Rebecca Sterner


A patient, legally blind from neurosyphilis and macular degeneration, was noted upon a low vision exam to have an area of markedly thinned sclera nasally O.S. He revealed a previous history of pterygia removal followed by irradiation forty years ago. Scleral necrosis is the primary complication of beta irradiation. It can occur years after treatment. Beta irradiation is used to reduce the recurrence of pterygia. Scleral necrosis has been infrequently reported following pterygia removal and irradiation. Scleral malacia can be graded upon the severity and extent of thinning. Grade 1 has an area of avascular episclera and sclera, grade two an avascular area which contains some scleral thinning, grade three shows thinning of at least half thickness of scleral thinning and more than 2 mm in diameter, grade 4 has more than half thickness scleral thinning larger than 4 mm in diameter, and grade 5 is full thickness scleral loss which leads to endophthalmitis and loss of the eye. This patient presented with grade 4 scleromalacia O.S. Treatment at this time is monitoring and lubricants. Lubrication at this stage can prevent further progression in certain patients. Since beta irradiation is still used, practitioners need to be aware of the potential for severe complications which can ccur years after such procedures.


Year: 1992

Program Number: Poster 54

Author Affiliation: n/a

Co-Authors: n/a

Co-Author Affiliation: n/a

Room: Great Hall