H15.059

Clinical Causes: Autoimmune diseases such as rheumatoid arthritis, systemic vasculitis, or polyarteritis nodosa. Chronic or recurrent inflammatory eye conditions. Certain infections leading to scleral inflammation. Idiopathic cases where no specific cause can be identified. History of ocular trauma or surgeries that weakens the scleral tissue.

Key Symptoms: Gradual or sudden vision changes or loss. Localized eye pain, which may be mild or severe. Redness in the affected eye. Visible thinning or bluish hue of the sclera where it is weakened. Presence of scleral perforation or bulging in affected areas. Possible sensation of a foreign body or discomfort. In advanced cases, signs of intraocular involvement, such as uveitis or keratitis.

Diagnosis Path: Diagnosing scleromalacia perforans involves a comprehensive eye examination, including slit-lamp biomicroscopy to inspect the scleral thinning and inflammation. Additional assessments might include imaging studies such as ultrasound biomicroscopy or anterior segment OCT to evaluate scleral integrity. Blood tests are often performed to identify associated autoimmune conditions, including rheumatoid factor, antinuclear antibodies (ANA), and inflammatory markers like ESR or CRP. A thorough review of medical history and systemic health is also crucial to determine underlying causes.

Treatment Protocols: Immunosuppressive medications such as corticosteroids or other DMARDs (disease-modifying antirheumatic drugs) to control inflammation and halt disease progression. Topical or systemic anti-inflammatory drugs to reduce scleral inflammation. Surgical interventions in cases of perforation or significant scleral thinning, including grafting or scleral reinforcement procedures. Regular monitoring and follow-up to assess scleral integrity and control systemic disease activity. Addressing underlying autoimmune or systemic conditions with appropriate specialists’ collaboration.