Document Type
Article
Publication Date
7-23-2025
Abstract
This study aims to provide an update on infectious scleritis (IS). A comprehensive search was conducted using Google Scholar, Scopus, and PubMed. IS is a rare but critical condition that presents significant diagnostic challenges and often leads to poor visual outcomes. It accounts for approximately 5%-10% of scleritis cases and warrants significant attention due to its delayed diagnosis. Ocular surgery is the primary contributor to IS, accounting for a substantial proportion of cases ranging from 58% to 83%, followed by trauma contributing to approximately 10% of cases. IS can be caused by various microorganisms, including bacteria (86%-87%), fungi (11%-13%), viruses, and parasites. Conjunctival hyperemia is a prevalent manifestation in approximately 98% of IS cases, while scleral necrosis is observed in around 93% of cases. Distinguishing IS from inflammatory scleritis before initiating steroid treatment is crucial. Surgical debridement of infected tissue, accompanied by appropriate topical and systemic antibiotic therapy significantly improves treatment outcomes by removing infected tissue and reducing the infection burden. Early surgical intervention markedly increases the likelihood of preserving the eye globe in severe cases. Risk factors for poor visual outcomes include poor visual acuity at presentation, associated endophthalmitis, keratitis, fungal etiology, and medical therapy without surgical debridement. Early diagnosis of IS is crucial as the disease can progress rapidly and lead to vision loss. While bacterial infections are the most common etiology of IS, the prognosis is particularly poor in cases of fungal IS. Surgical interventions, when combined with appropriate medical treatment, improve outcomes.
Recommended Citation
Ghanbari, Hamidreza; Rahimi, Masoud; Momeni, Ali; Hassanpour, Kiana; Bayan, Nikoo; Lee, Karen E.; Hansen, Alex; Djalilian, Ali R.; Rapuano, Christopher J.; and Soleimani, Mohammad, "Infectious Scleritis: A Comprehensive Narrative Review of Epidemiology, Clinical Characteristics, and Management Strategies" (2025). Wills Eye Hospital Papers. Paper 267.
https://jdc.jefferson.edu/willsfp/267
Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial 4.0 License
PubMed ID
40718796
Language
English
Included in
Epidemiology Commons, Eye Diseases Commons, Ophthalmology Commons, Pathological Conditions, Signs and Symptoms Commons
Comments
This article is the author’s final published version in Therapeutic Advances in Ophthalmology, Volume 17, 2025, Article number 25158414251357776.
The published version is available at https://doi.org/10.1177/25158414251357776. Copyright © The Author(s), 2025.