Staphyloma Episcleritis Scleritis

Ectasia of outer coat lined by atrophic middle +/- inner Etiology 1. Non-infective : 50% with rheumatoid arthritis
coat . 2. infective : herpes zoster
3. idiopathic
Anterior staphyloma Types 1) Diffuse 1) Diffuse
2) Nodular 2) Nodular
Healing of a large perforated corneal ulcer forming an 3) Necrotizing : may result in
ectatic scar in which the iris is incarcerated. perforation

4) scleromalacia perforans :
scleral melting {rare
perforation}
5) posterior scleritis : +/-
Scleral staphyloma exudative retinal detachment.

Clinical picture Discomfort and lacrimation + Severe pain

The sclera bulges either because of a
Redness - Tenderness +/- blurred vision
 high IOP as in absolute glaucoma or
 weakness of the sclera as in scleritis Complications 1) Uveitis
2) keratitis
The sclera yields at the site of weakness: 3) Staphyloma

1) intercalary : at the limbus – lined by root of iris Treatment  Of cause +/- atropine
 NSAID +/- oral steroids
2) ciliary: at anterior ciliary vessels – lined by ciliary
 topical steroids +/- immunosuppressive
body
3) equatorial : at the vortex veins - lined by choroid DD Phlycten
and retina

DD of a blue sclera
1. Neonates
2. Buphthalmos
3. High axial myopia
4. Over staphyloma
5. Osteogenesis imperfecta { deafness - fragile bones

Treatment :
if blind, ugly and painful = evisceration or enucleation

NB :posterior staphyloma :
 in cases with high axial myopia
 seen by fundus or US .