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Sclera

Staphyloma is an ectasia of the outer coat of the eye where the middle and sometimes inner coats bulge out. It can be anterior from a perforated corneal ulcer or scleral from high pressure or scleral weakness. Scleritis causes severe pain and redness from inflammation of the sclera. It can be diffuse, nodular, necrotizing causing perforation, or posterior with exudative retinal detachment. Treatment involves treating the underlying cause with NSAIDs, steroids, or immunosuppressants to prevent complications like uveitis, keratitis, or further staphyloma formation.

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Mohamed Ghanem
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442 views1 page

Sclera

Staphyloma is an ectasia of the outer coat of the eye where the middle and sometimes inner coats bulge out. It can be anterior from a perforated corneal ulcer or scleral from high pressure or scleral weakness. Scleritis causes severe pain and redness from inflammation of the sclera. It can be diffuse, nodular, necrotizing causing perforation, or posterior with exudative retinal detachment. Treatment involves treating the underlying cause with NSAIDs, steroids, or immunosuppressants to prevent complications like uveitis, keratitis, or further staphyloma formation.

Uploaded by

Mohamed Ghanem
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© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Staphyloma Episcleritis Scleritis

Ectasia of outer coat lined by atrophic middle +/- inner Etiology 1. Non-infective : 50% with rheumatoid arthritis
coat . 2. infective : herpes zoster
3. idiopathic
Anterior staphyloma Types 1) Diffuse 1) Diffuse
2) Nodular 2) Nodular
Healing of a large perforated corneal ulcer forming an 3) Necrotizing : may result in
ectatic scar in which the iris is incarcerated. perforation

4) scleromalacia perforans :
scleral melting {rare
perforation}
5) posterior scleritis : +/-
Scleral staphyloma exudative retinal detachment.

Clinical picture Discomfort and lacrimation + Severe pain


The sclera bulges either because of a
Redness - Tenderness +/- blurred vision
 high IOP as in absolute glaucoma or
 weakness of the sclera as in scleritis Complications 1) Uveitis
2) keratitis
The sclera yields at the site of weakness: 3) Staphyloma

1) intercalary : at the limbus – lined by root of iris Treatment  Of cause +/- atropine
 NSAID +/- oral steroids
2) ciliary: at anterior ciliary vessels – lined by ciliary
 topical steroids +/- immunosuppressive
body
3) equatorial : at the vortex veins - lined by choroid DD Phlycten
and retina

DD of a blue sclera
1. Neonates
2. Buphthalmos
3. High axial myopia
4. Over staphyloma
5. Osteogenesis imperfecta { deafness - fragile bones

Treatment :
if blind, ugly and painful = evisceration or enucleation

NB :posterior staphyloma :
 in cases with high axial myopia
 seen by fundus or US .

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