Epidemiology and visual outcomes in patients with infectious scleritis.
OBJECTIVE
To describe the epidemiology of patients with infectious scleritis and identify factors associated with poor visual prognosis.


METHODS
Retrospective review of inciting factors, causative organisms, and visual outcomes of patients with infectious scleritis.


RESULTS
Fifty-five patients (56 eyes) with confirmed infectious scleritis were included. The median time from inciting event to scleritis symptoms was 1.9 months. Eyes with a history of pterygium surgery had a longer time from surgery to development of scleritis (median 49 months, range 0-183) compared to those with a history of glaucoma, cataract, and retina surgery (median 1.0-1.6 months; P = 0.001). Fungal, nocardial, and mycobacterial infections (median 17-45 days) had a longer interval between symptoms and diagnosis than eyes with non-acid-fast gram-positive and gram-negative bacteria (median 7 days; P = 0.04). Patients were followed for a median of 11.1 months (0.5-47 months). Approximately 50% of eyes lost functional vision (worse than 20/200). Presenting VA of worse than 20/200 and concomitant keratitis or endophthalmitis were associated with poorer VA outcomes.


CONCLUSIONS
Infectious scleritis can occur days to years after ocular surgery, with infection occurring after a longer interval in eyes with a history of pterygium surgery. Approximately 50% of eyes lost functional VA after infection with poor presenting VA being the strongest predictor for subsequent severe vision loss.
Ophthalmology Department, Bascom Palmer Eye Institute, University of Miami, Miami, FL 33136, USA.
Kelly L
KL
Hodson
Anat
A
Galor
Carol L
CL
Karp
Janet L
JL
Davis
Thomas A
TA
Albini
Victor L
VL
Perez
Darlene
D
Miller
Richard K
RK
Forster
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000890:Anti-Infective Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D015818:Eye Infections, Bacterial / Q000188:drug therapy / Q000453:epidemiology*; D015821:Eye Infections, Fungal / Q000188:drug therapy / Q000453:epidemiology*; D005260:Female; D005431:Florida / Q000453:epidemiology; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D015423:Scleritis / Q000453:epidemiology* / Q000382:microbiology / Q000628:therapy; D014792:Visual Acuity; D055815:Young Adult
D000890:Anti-Infective Agents