Our Summary

This research paper discusses a rare but severe issue called surgically induced necrotizing scleritis (SINS), which can happen days to years after eye surgery. The study shares the case of a 32-year-old man who had a straightforward eye surgery for a condition known as large-angle exotropia. Unfortunately, he developed SINS shortly after his surgery, which involved a type of inflammation in the white part of the eye, exposure of a layer of the eye called the choroid, and an abnormal bulging of his eyeball. Tests showed no signs of infection or an underlying inflammatory condition. He was successfully treated with oral immunosuppressive drugs and didn’t need a graft, or transplant.

FAQs

  1. What is surgically induced necrotizing scleritis (SINS)?
  2. What symptoms may indicate the development of SINS after ocular surgery?
  3. What kind of treatment was effective for the case of SINS mentioned in the article?

Doctor’s Tip

A helpful tip a doctor might tell a patient about ocular surgery is to closely follow post-operative instructions, including taking prescribed medications as directed and attending follow-up appointments. It is important to report any unusual symptoms or changes in vision to your doctor immediately to prevent complications such as surgically induced necrotizing scleritis.

Suitable For

Patients who may be recommended for ocular surgery include those with refractive errors such as nearsightedness, farsightedness, or astigmatism, cataracts, glaucoma, retinal detachment, strabismus, or other eye conditions that cannot be corrected with glasses or contact lenses. It is important to note that while ocular surgery can provide significant benefits for many patients, there are risks involved, including the potential for complications such as surgically induced necrotizing scleritis. Patients should discuss the risks and benefits of surgery with their ophthalmologist before proceeding.

Timeline

Before ocular surgery:

  • Patient consults with ophthalmologist and undergoes pre-operative testing
  • Patient receives pre-operative instructions and medications
  • Patient undergoes ocular surgery as planned

After ocular surgery:

  • Patient may experience pain, discomfort, and inflammation in the operated eye
  • Patient is monitored closely for signs of infection or other complications
  • Patient may need to take medications to prevent infection and promote healing
  • Patient may undergo follow-up appointments to monitor progress and adjust treatment as needed
  • Patient may experience improvement in vision and relief from pre-operative symptoms
  • Depending on the type of surgery, patient may need to undergo rehabilitation or follow-up procedures

In the case of surgically induced necrotizing scleritis:

  • Patient develops painless scleral inflammation, choroidal exposure, and globe ectasia within days of surgery
  • Work-up reveals no associated infectious process or underlying systemic inflammatory condition
  • Clinical resolution occurs with oral immunosuppression alone, without need for graft.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with the ocular surgery I am considering?
  2. How long is the recovery period after the surgery and what can I expect during this time?
  3. Will I need any follow-up appointments or additional treatments after the surgery?
  4. What type of anesthesia will be used during the surgery and what are the associated risks?
  5. How experienced are you in performing this type of surgery and what is your success rate?
  6. Are there any alternative treatment options to consider before proceeding with surgery?
  7. What can I do to prepare for the surgery and optimize my chances for a successful outcome?
  8. Will I need to take any medications before or after the surgery, and if so, what are the potential side effects?
  9. How will my vision be affected after the surgery and what can I expect in terms of long-term results?
  10. What should I do if I experience any unusual symptoms or complications after the surgery?

Reference

Authors: Yu SN, Talsania SD. Journal: J AAPOS. 2023 Oct;27(5):293-295. doi: 10.1016/j.jaapos.2023.07.003. Epub 2023 Aug 23. PMID: 37625780