Surgically induced necrotizing scleritis after retinal detachment surgery masquerading as scleral abscess

Abstract

Scleral necrosis is a rare occurrence after many ocular procedures. In the absence of infection or use of surgical adjuncts such as antimetabolites or radiation, the necrosis is presumed to be directly related to surgical trauma and is hence termed surgically induced necrotizing scleritis (SINS). A high index of suspicion is required for an early diagnosis of SINS and its differentiation from infective scleritis is important as the treatment modalities of these two related conditions are different. We report a case of SINS at sclerotomy site following 23-gauge transconjunctival retinal detachment surgery that was initially suspected to be a scleral abscess. Prompt recognition and institution of topical and systemic steroid therapy helped in limiting the extent of scleral damage