Etiology, Pathogens, Clinical Features and Treatment of Bacterial Scleritis

We retrospectively reviewed literature reports on pathogens, clinical features, diagnosis, treatment, and clinical and visual outcomes in patients with bacterial scleritis over the past decade. Eye surgery and trauma are the most common causes of bacterial infections. Subtenon triamcinolone acetonide injection, intravitreal ranibizumab, and wearing contact lenses are also causes of bacterial scleritis. Pseudomonas aeruginosa is the most common pathogenic microorganism causing bacterial scleritis. Mycobacterium tuberculosis ranks second. The main symptoms of bacterial scleritis are red and painful eyes. The patient's visual acuity decreased significantly. Bacterial scleritis caused by Pseudomonas aeruginosa often manifests as necrotizing scleritis, tuberculous scleritis and syphilitic scleritis are mostly nodular scleritis. Bacterial scleritis often involves the cornea, and approximately 37.6% (32 eyes) of patients had corneal bacterial infection. Hyphema was present in 18.8% (16 eyes). Elevated intraocular pressure was observed in 36.5% (31 eyes) of patients. Bacterial culture was an effective method of diagnosis. Most bacterial scleritis cases require both aggressive medical and surgical treatment, and the drug choice must be based on antibiotic susceptibility testing.