title: Surgically Induced Necrotizing Scleritis Following Strabismus Surgery Treated Successfully with Topical N-acetylcysteine in a Child with Congenital Fibrosis of Extraocular Muscles and Varadi Papp Syndrome.
abstract: Surgically induced necrotizing scleritis (SINS) is a rare but serious disorder that can develop many years after strabismus surgery. It is generally treated with high-dose steroids or immunosuppression.
  
  
  
  We describe a patient with Varadi Papp syndrome and congenital fibrosis of the extraocular muscles, who developed surgically induced necrotizing scleritis a month after strabismus surgery and was successfully managed by oral vitamin C and topical N-acetylcysteine 10%.
  
  
  
  While SINS is conventionally treated with steroids/immunosuppression, a conservative approach may be tried in milder cases. The role of topical N-acetylcysteine in managing this complication needs to be explored.
authors.affiliation: b Department of Pediatric Ophthalmology and Strabismus , The Eye Foundation , Coimbatore , India.
authors.forename: Muralidhar
authors.initials: M
authors.lastname: Rajamani
authors.affiliation: b Department of Pediatric Ophthalmology and Strabismus , The Eye Foundation , Coimbatore , India.
authors.forename: Vidhya
authors.initials: V
authors.lastname: Nagasubramanian
authors.affiliation: a Department of Paediatric Endocrinology and Diabetes , G. Kuppuswamy Naidu Memorial Hospital , Coimbatore , India.
authors.forename: Ahila
authors.initials: A
authors.lastname: Ayyavoo
authors.affiliation: a Department of Paediatric Endocrinology and Diabetes , G. Kuppuswamy Naidu Memorial Hospital , Coimbatore , India.
authors.forename: Palany
authors.initials: P
authors.lastname: Raghupathy
authors.affiliation: b Department of Pediatric Ophthalmology and Strabismus , The Eye Foundation , Coimbatore , India.
authors.forename: Ramamurthy
authors.initials: R
authors.lastname: Dandapani
mesh_terms: D000111:Acetylcysteine / Q000627:therapeutic use*; D000287:Administration, Topical; D001205:Ascorbic Acid / Q000008:administration & dosage; D002648:Child; D005355:Fibrosis / Q000150:complications*; D016166:Free Radical Scavengers / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D009801:Oculomotor Muscles / Q000601:surgery; D009883:Ophthalmic Solutions; D013508:Ophthalmologic Surgical Procedures / Q000009:adverse effects*; D009886:Ophthalmoplegia / Q000150:complications*; D009958:Orofaciodigital Syndromes / Q000150:complications*; D011183:Postoperative Complications; D015423:Scleritis / Q000188:drug therapy / Q000209:etiology*; D013285:Strabismus / Q000601:surgery*; D000093922:Congenital Cranial Dysinnervation Disorders
chemical_list: D016166:Free Radical Scavengers; D009883:Ophthalmic Solutions; D001205:Ascorbic Acid; D000111:Acetylcysteine
keywords: Congenital fibrosis of extraocular muscles; Varadi Papp syndrome; oral vitamin C; surgically induced necrotizing scleritis; topical N-acetylcysteine; treatment