title: Necrotizing scleritis as a complication of cosmetic eye whitening procedure.
abstract: BACKGROUND
  We report necrotizing scleritis as a serious complication of a cosmetic eye whitening procedure that involves the use of intraoperative and postoperative topical mitomycin C.
  
  
  RESULTS
  This is a single case report. A 59-year-old Caucasian male with a history of blepharitis status post uncomplicated LASIK refractive surgery reported chronic conjunctival hyperemia for 15 years prior to undergoing a cosmetic eye whitening procedure. He presented to our clinic 12 months after the cosmetic eye whitening procedure with progressive bilateral necrotizing scleritis and scleral calcification.
  
  
  CONCLUSIONS
  Chronic conjunctival hyperemia may prompt patients to seek surgical correction with cosmetic eye whitening procedures. However, conjunctival hyperemia secondary to tear deficiency and evaporative dry eye may predispose to poor wound healing. Serious complications including necrotizing scleritis may result from cosmetic eye whitening procedures and the use of topical mitomycin C.
authors.affiliation: The Division of Ocular Immunology, The Wilmer Eye Institute, Johns Hopkins School of Medicine, 600 North Wolfe Street, Woods Building, Room 476, Baltimore, MD 21287, USA. tgan1@jhmi.edu.
authors.forename: Theresa G
authors.initials: TG
authors.lastname: Leung
authors.forename: James P
authors.initials: JP
authors.lastname: Dunn
authors.forename: Esen K
authors.initials: EK
authors.lastname: Akpek
authors.forename: Jennifer E
authors.initials: JE
authors.lastname: Thorne