title: Multifocal Surgically Induced Necrotizing Scleritis Following Strabismus Surgery: A Case Report.
abstract: OBJECTIVE
  To present clinical findings of a 28-year-old woman with multifocal surgically induced necrotizing scleritis following uncomplicated strabismus surgery.
  
  
  METHODS
  A 28-year-old woman underwent uncomplicated strabismus surgery of her right eye for sensory exotropia under general anesthesia (6 mm right medial rectus muscle resection and 8 mm right lateral rectus muscle recession).
  
  
  METHODS
  Retrospective, observational case report and literature review.
  
  
  RESULTS
  One month after strabismus surgery, the patient presented with surgically induced necrotizing scleritis in the nasal aspect of sclera. Bacterial culture of the bed of the scleral melt showed no growth and all laboratory evaluation was normal. The scleritis completely resolved after initiation of systemic corticosteroids and oral azathioprine. Three weeks later (after tapering dose of systemic medication), the patient returned with large area of necrotizing scleritis in the same eye, but this time in the temporal aspect of sclera.
  
  
  CONCLUSIONS
  To our knowledge, this is the first documented case of multifocal surgically induced necrotizing scleritis occurring after strabismus surgery. This study also highlights the fact that scleritis may recur even in an area distant from the site of surgery, despite initial control. It seems that maybe with a longer course of treatment it is less likely to recur, and tapering medications should be carefully managed.
authors.affiliation: a Eye Research Center , Farabi Eye Hospital, Tehran University of Medical Sciences , Tehran , Iran.
authors.forename: Mohammad Reza
authors.initials: MR
authors.lastname: Akbari
authors.affiliation: a Eye Research Center , Farabi Eye Hospital, Tehran University of Medical Sciences , Tehran , Iran.
authors.forename: Masoomeh
authors.initials: M
authors.lastname: Mohebbi
authors.affiliation: a Eye Research Center , Farabi Eye Hospital, Tehran University of Medical Sciences , Tehran , Iran.
authors.forename: Mohammadkarim
authors.initials: M
authors.lastname: Johari
authors.affiliation: a Eye Research Center , Farabi Eye Hospital, Tehran University of Medical Sciences , Tehran , Iran.
authors.forename: Arash
authors.initials: A
authors.lastname: Mirmohammadsadeghi
authors.affiliation: a Eye Research Center , Farabi Eye Hospital, Tehran University of Medical Sciences , Tehran , Iran.
authors.forename: Alireza
authors.initials: A
authors.lastname: Mahmoudi
mesh_terms: D000328:Adult; D005099:Exotropia / Q000601:surgery*; D005260:Female; D006801:Humans; D009801:Oculomotor Muscles / Q000601:surgery*; D013508:Ophthalmologic Surgical Procedures / Q000009:adverse effects*; D011183:Postoperative Complications; D012189:Retrospective Studies; D015423:Scleritis / Q000209:etiology*
keywords: Multifocal scleritis; necrotizing scleritis; strabismus surgery