Pseudomonas Scleritis following Pterygium Excision

Area of Science:

• Ophthalmology
• Infectious Diseases
• Surgical Complications

Background:

• Pterygium excision is a common ophthalmic procedure.
• Infectious scleritis is a serious complication that can lead to scleral melting and vision loss.
• Pseudomonas aeruginosa is a highly virulent bacterium known for causing severe infections.

Observation:

• A 66-year-old male developed Pseudomonas scleritis 10 years after pterygium excision.
• Clinical presentation included scleral thinning, tissue necrosis, and a calcified plaque.
• Scleral scraping confirmed Pseudomonas aeruginosa infection.

Findings:

• Treatment involved topical fortified amikacin and intravenous ceftazidime.
• Surgical debridement of necrotic sclera and irrigation were performed.
• Within two weeks, scleral thinning and inflammation improved, with visual acuity increasing from 6/24 to 6/9.

Implications:

• Pseudomonas aeruginosa can cause necrotizing scleritis, a severe complication of pterygium excision.
• Early recognition and aggressive management, including antibiotics and surgical debridement, are crucial.
• Prompt treatment can prevent significant morbidity and preserve visual function.