Bilateral necrotising scleritis with marginal corneal ulceration after cataract surgery in a patient with vasculitis

The onset of bilateral necrotising scleritis and marginal corneal ulceration after cataract surgery are described in a patient with diffuse vasculitis syndrome. The finding of immune complexes in this patient's tissue biopsy suggests that they are the cause of a localised primary vasculitis triggered by surgical inflammation. Clinically, this patient's marginal corneal ulceration preceded the scleral necrosis. A past history of orbital inflammation may have been due to a posterior scleritis. The corneal ulcerations responded to conjunctival debridement and steroids. The scleral necrosis was unresponsive to the 2 anti-inflammatory preparations tried, and the patient eventually went into remission while off all treatment.