Atypical Noninfectious Surgically Induced Necrotizing Scleritis in a Child

Surgically induced necrotizing scleritis (SINS) is recognized as a rare and vision-threatening complication of ocular surgery. In adults, it has been mostly described after multiple ocular surgical procedures such as pterygium excision, glaucoma, and retinal detachment in the same eye. SINS is relatively less likely with single ocular surgery. It has been postulated that multiple surgeries may result in exposure of an antigen that leads to hypersensitivity reaction. Interestingly, it has also been reported after single strabismus surgery in adults. We present a case of unilateral surgically induced scleral necrosis resulting in complete loss of left inferior rectus muscle and muscle sheath in a child 2 weeks after uneventful bilateral strabismus surgery for hypertropia.