Ocular System

Surgically induced necrotizing scleritis (SINS)


Delayed hypersensitivity reaction occurring after any ocular surgery involving scleral incisions.

Surgically induced necrotizing scleritis at the sclerotomy site after vitrectomy: With intense conjunctival congestion, exudation at the sclerotomy site and presence of discharge on the fifth postoperative day, scleral abscess was suspected (A). After intense systemic and topical steroid therapy, resolving necrotizing scleritis with reduction in prominence of scleral induration can be seen at 1 week (B). At two months, scleritis has resolved completely with consequent scleral thinning (C). Uveal show can also be seen. | Madanagopalan, V. G., Shivananda, N., & Krishnan, T. (2019). Surgically induced necrotizing scleritis after retinal detachment surgery masquerading as scleral abscess. GMS ophthalmology cases, 9, Doc18.


Common surgical causes:

  • Cataract surgery
  • Pterygium excision


Systemic immunosuppressive therapy:

  • Cyclophosphamide, or tacrolimus

Surgical management:

  • Resection of necrotic tissue
  • Amniotic membrane transplantation
  • Scleral/corneal tissue patch grafts

Leave a Reply

%d bloggers like this: