Necrotizing anterior scleritis can be associated with which ocular complication?

• A. Scleral thinning
• B. Secondary glaucoma
• C. Peripheral corneal melt
• D. All of the above

Answer: (D)

Necrotizing anterior scleritis is a severe, destructive inflammatory process that can extend beyond the sclera to involve adjacent ocular tissues. The aggressive inflammation leads to scleral thinning (scleromalacia) as tissue is destroyed by the inflammatory milieu, which raises the risk of scleral perforation if not treated promptly. The inflammation can also extend to the limbal region and cornea, causing peripheral corneal melt where corneal tissue is degraded and integrity is compromised. In addition, inflammatory involvement of the anterior chamber and trabecular meshwork, along with possible corticosteroid treatment, can contribute to secondary glaucoma. Because these complications can all arise from this aggressive condition, all of the above are potential associations with necrotizing anterior scleritis.