Cornea & External Diseases-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.

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