Iatrogenic conjunctival entrapment of cilium and scleral ulceration after subtenon steroid injection.
OBJECTIVE
To report the presence of an asymptomatic cilium in the subconjunctival area and an adjacent sterile scleral ulcer, together as a complication of subtenon injection of steroids, and the resolution of the ulcer despite the in situ cilium.


METHODS
Medical management of a 51-year-old man, who was a known case of ankylosing spondylitis, with a 3-mm scleral ulcer located in the inferior palpebral area with one adjacent fully embedded cilium at the probable site of subtenon injection given for suspected acute iridocyclitis.


RESULTS
On altering the medication, the ulcer resolved completely. This occurred despite the in situ cilium, which did not act as a nidus for infection or inflammation.


CONCLUSIONS
The presence of cilia did not adversely affect the outcome of treatment of the adjacent ulcer. Therefore, if there is no exposure of the entrapped cilium through the conjunctiva, as was in this case, conservative management of the ulcer and not trying to remove the cilium seems to be a good alternative as opposed to reports in literature, which warrant its removal in most cases.
Prakash
Gaurav
G
Cornea and Refractive Surgery Services, Dr Rajendra Prasad Centre for Ophthalmic Sciences, Ansari Nagar, New Delhi, India. drgauravprakash@gmail.com
Sharma
Namrata
N
Tandon
Radhika
R
Titiyal
Jeewan S
JS
D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D001205:Ascorbic Acid / Q000008:administration & dosage; D002266:Carboxymethylcellulose Sodium / Q000008:administration & dosage; D002701:Chloramphenicol / Q000008:administration & dosage; D002923:Cilia; D003229:Conjunctival Diseases / Q000209:etiology* / Q000473:pathology; D004359:Drug Therapy, Combination; D005129:Eye Foreign Bodies / Q000209:etiology* / Q000473:pathology; D006801:Humans; D007049:Iatrogenic Disease; D056965:Injections, Intraocular / Q000009:adverse effects*; D015863:Iridocyclitis / Q000150:complications / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D015422:Scleral Diseases / Q000188:drug therapy / Q000209:etiology*; D013167:Spondylitis, Ankylosing / Q000150:complications; D013256:Steroids / Q000008:administration & dosage*; D013752:Tetracycline / Q000008:administration & dosage; D014456:Ulcer / Q000188:drug therapy / Q000209:etiology*; D014815:Vitamins / Q000008:administration & dosage
D000900:Anti-Bacterial Agents; D013256:Steroids; D014815:Vitamins; D002701:Chloramphenicol; D013752:Tetracycline; D002266:Carboxymethylcellulose Sodium; D001205:Ascorbic Acid