Dr. ANIRBAN DUTTA

Dr.Smruti Rekha Priyadarshini, Dr.Sujata Das

Abstract

A 57 year old female complained of redness and pain in the right eye for 5 months. She was a known case of polyarthritis on oral steroids. Examination revealed peripheral corneal thinning with diffuse necrotising scleritis of the right eye. Physical examination revealed digital gangrene of the hands which eventually underwent autoamputation. She received tissue adhesive application for the obvious corneal melt. Laboratory reports revealed elevated ESR and c-ANCA positivity. Rheumatologist opinion was sought. Topical steroids, oral azathioprine and IV cyclophosphamide were started, and oral steroids continued. The signs and symptoms resolved with corneal scarring. About 6 months later, she complained of similar symptoms and examination revealed scleral melt of the same eye. Scleral exploration was performed and infective etiology was ruled out. Topical steroids were restarted under cover of systemic immunosuppression. Corneal and scleral scarring with thinning was noted on last visit.