title: Risk factors and clinical outcomes of bacterial and fungal scleritis at a tertiary eye care hospital.
abstract: OBJECTIVE
  The aim was to analyze demographics, risk factors, pathogenic organisms, and clinical outcome in cases with microbiologically proven bacterial or fungal scleritis.
  
  
  METHODS
  Retrospective review of all the medical records of patients with microbiologically proven infectious scleritis examined from March 2005 to December 2009 in the cornea services of L. V. Prasad Eye Institute, Hyderabad, India was done.
  
  
  RESULTS
  Forty-two eyes of 42 patients were included in this study. The mean age at presentation was 48.52 ± 14.10 years (range: 12-70). Surgery was the major risk factor seen in 24 eyes (58.5%). Scleral infection was noted after vitreoretinal surgery (with scleral buckle) in 15 eyes, cataract surgery in 3 eyes, pterygium surgery in 3 eyes, corneoscleral tear repair and scleral buckle surgery in 3 eyes. Sixteen eyes (39%) were on systemic or topical steroids at the time of presentation. History of injury was noted in 9 eyes (22%) and diabetes mellitus in 7 patients (17%). Associated keratitis was noted in 9 eyes (21.4%). The scleral abscess was unifocal in 33 eyes (78.5%), multifocal in 6 eyes (14.2%) and diffuse in 3 eyes (7.14%). The final follow-up ranged from 24 days to 37 months. The final visual acuity was better in 18 eyes (42.8%), stable in 13 (30.9%), and deteriorated in 7 eyes (16.6%). Recurrence was seen in 4 eyes (9.5%).
  
  
  CONCLUSIONS
  Surgery is a major risk factor for infectious scleritis in our series. Fungus was the most common organism isolated. Thorough debridement and intensive use of medications have improved the outcome.
authors.affiliation: Department of Cornea, Anterior Segment and Refractive Surgery Services, Hyderabad, Andhra Pradesh, India.
authors.forename: Jagadesh C
authors.initials: JC
authors.lastname: Reddy
authors.affiliation: Jhaveri Microbiology Centre, Hyderabad, Andhra Pradesh, India.
authors.forename: Somasheila I
authors.initials: SI
authors.lastname: Murthy
authors.affiliation: Department of Cornea, L. V. Prasad Eye Institute, Kallam Anji Reddy Campus, Hyderabad, Andhra Pradesh, India.
authors.forename: Ashok K
authors.initials: AK
authors.lastname: Reddy
authors.affiliation: Department of Cornea, Anterior Segment and Refractive Surgery Services, Hyderabad, Andhra Pradesh, India.
authors.forename: Prashant
authors.initials: P
authors.lastname: Garg
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001419:Bacteria / Q000302:isolation & purification; D002648:Child; D003646:Debridement; D015818:Eye Infections, Bacterial / Q000175:diagnosis / Q000382:microbiology* / Q000628:therapy; D015821:Eye Infections, Fungal / Q000175:diagnosis / Q000382:microbiology* / Q000628:therapy; D005131:Eye Injuries / Q000209:etiology; D005260:Female; D005658:Fungi / Q000302:isolation & purification; D006801:Humans; D007194:India; D008297:Male; D008875:Middle Aged; D013508:Ophthalmologic Surgical Procedures; D012189:Retrospective Studies; D012307:Risk Factors; D015423:Scleritis / Q000175:diagnosis / Q000382:microbiology* / Q000628:therapy; D062606:Tertiary Care Centers; D014792:Visual Acuity
chemical_list: D000900:Anti-Bacterial Agents
keywords: Bacterial; Debridement; Fungal; Infectious Scleritis; Outcomes; Risk Factors