Scleral perforation in a young adult with Burkitt lymphoma

A male in his 20s with Burkitt lymphoma (BL) treated with chemotherapy was referred for lagophthalmos and left facial nerve palsy and re-evaluated weeks later due to acute scleral perforation.The perforated area was surgically closed, but on the first postoperative day, corneal thinning down to the Descemet membrane was noted, with iris adherence to the endothelium and progressive expansion of the affected sclera. Further globe reconstruction was deemed impossible; therefore, enucleation was performed. Histopathology revealed keratoconjunctivitis and acute perforative scleritis, though the aetiology could not be determined. A review of internal medicine records identified Pseudomonas aeruginosa bacteraemia, which may have been the underlying cause of the ocular condition.Intraocular involvement in BL is rare, and although P. aeruginosa is a leading cause of infective necrotising scleritis, scleral perforation due to this bacterium without prior surgery has not been reported.