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Objective: To report a case series of non-infectious anterior scleritis resistant to multiple lines of conventional therapies which were eventually successfully treated with off-label subconjunctival dexamethasone implant (Ozurdex) injection (SDI).
Methods: A retrospective case series of 4 patients (6 eyes).
Results: In the index case series, the patients had a mean age of 57.2 years (range 36 to 82 years, SD 19.2 years) with 50% being female. Two patients had underlying autoimmune diseases: rheumatoid arthritis (n = 1), and granulomatosis with polyangiitis (GPA) (n = 1). The other patients were diagnosed with idiopathic anterior scleritis after extensive systemic investigations (n = 2). The mean follow-up duration and the mean number of concomitant therapies prior to SDI was 27 (SD 17.7) months and 2 (SD 0.81), respectively. In all patients, symptom resolution and significant improvement in disease activity were achieved after SDI, persisting for an extended period following the resorption of the implant. No scleral melt, infection or ocular hypertension were noted following SDI.
Conclusion: SDI may be a safe and effective therapeutic option for resistant non-infectious anterior scleritis.
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http://dx.doi.org/10.1186/s12348-025-00494-6 | DOI Listing |
Cureus
August 2025
Department of Ophthalmology, Hôpital Maisonneuve-Rosemont, Montreal, CAN.
Choroidal metastasis from occult cutaneous melanoma is rare and can masquerade as ocular inflammation. A 70‑year‑old man with sectoral anterior scleritis was found on multimodal imaging to have a solitary choroidal mass with mild periscleral fluid, prompting systemic evaluation that uncovered colonic polyps that, on histopathology, contained metastatic melanoma, a scalp primary, and widespread visceral, nodal, and intracranial metastases. Tumour cells stained HMB‑45, Melan‑A, and SOX10 positive, AE1/AE3 negative, and carried an NRAS‑Q61 mutation with wild‑type BRAF, confirming cutaneous origin.
View Article and Find Full Text PDFBMC Ophthalmol
August 2025
B.P. Eye Foundation, Children's Hospital for Eye, ENT and Rehabilitation Services, Bhaktapur, Nepal.
Purpose: Seasonal Hyperacute Panuveitis (SHAPU) is a severe, rapid-onset panuveitis primarily affecting children, often linked to the setae released in the air or by contact with female moths of the genus Gazalina (Lepidoptera, Notodontidae), or with their egg masses laid on various substrates. This study aims to report a rare case of SHAPU from the higher altitude of Nepal with an alpine climate, with concurrence of necrotising scleritis. To the best of our knowledge, this is the first report of SHAPU at high elevation.
View Article and Find Full Text PDFTher Adv Ophthalmol
August 2025
Department of Ophthalmology, University of Szeged, Szeged, Hungary.
Scleritis is a rare, potentially sight-threatening, painful eye disease. Based on its anatomical involvement, it can be categorized as anterior and posterior scleritis. There are several possible causes, among which infectious and noninfectious origins should be considered.
View Article and Find Full Text PDFJ Ophthalmic Inflamm Infect
August 2025
Department of Ophthalmology and Visual Sciences, University of Alabama School of Medicine, 1720 University Boulevard, Suite 302, Birmingham, AL, 35233, USA.
Purpose: To report a case of chronic unilateral nodular anterior scleritis as a rare, isolated presentation of IgG4-related ophthalmic disease.
Case: A fifty-two-year-old patient was evaluated for painful, nodular scleral injection of the right eye, diagnosed as nodular anterior scleritis. There was only a partial response to topical corticosteroid and systemic immunomodulatory therapy.
We report a case of atypical new-onset herpetic necrotizing sclerokeratitis after implantable collamer lens surgery. A 37-year-old healthy Saudi female, known to have keratoconus underwent keratoplasty 14 years ago, followed by implantable collamer lens surgery (ICL) for visual rehabilitation nine months ago in the left eye. She presented to our institute with a history of subacute painful ocular pain and redness in her left eye over seven months.
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