All except one are true for Scleromalacia perforans
Correct Answer: It affects only males
Description: Ans. is 'b' i.e., It affects only males Scleromalacia perforans* Scleromalacia perforans (5% of scleritis) is a specific type of progressive scleral thinning without inflammation that typically affects elderly women with longstanding rheumatoid arthritis, but has also been described in association with other systemic disorders. Despite the nomenclature, perforation of the globe is extremely rare as integrity is maintained by a thin layer of fibrous tissue. Differential diagnosis is from the innocuous scleral hyaline plaque and senile scleromalacia.* Symptoms : Mild non-specific irritation; pain is absent and vision unaffected, and keratoconjunctivitis sicca may be suspected.* Signs# Necrotic scleral plaques near the limbus without vascular congestion.# Coalescence and enlargement of necrotic areas.# Slow progression of scleral thinning with exposure of underlying uvea.* Treatment may be effective in patients with early disease but by the time of typical presentation, either no treatment is needed or progression has been marked.* Consistent benefit from any agent has not been demonstrated, though frequent lubricant instillation, local (including topical sodium versenate) or systemic anticollagenase agents, immunosuppressives (including topical and oral, but not periocular injection of, steroids, and topical ciclosporin) and biological blockers have been used.# Underlying systemic disease should be treated aggressively.# Protection from trauma is important.# Surgical repair of scleral perforation (e.g. patch grafting) is mandatory to prevent phthisis bulbi.
Category:
Ophthalmology
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