Scleral Thinning

Scleral thinning in a patient with history of pterygium surgery and mitomycin-C application. 

  • Topical antimetabolites such as mitomycin-C or triethylene thiophosphamide have been routinely used as an adjunctive therapy after pterygium removal surgery to decrease the likelihood of recurrency.
  • May be complicated with corneal or scleral thinning, ulceration and necrosis especially when bare scleral technique is applied.

Clinical features:

  • Symptoms: may be asymptomatic or associated with ocular irritation
  • Signs:
    • Scleral thinning with trans-sclerally visible choroid
    • Hyperemia of the overlying conjunctiva
    • May progress to scleral perforation

Management:

  • Observation, if asymptomatic and no evidence of perforation.
  • Surgical patch grafts to reinforce the thinning sclera.