Background
We report necrotizing scleritis as a serious complication of a cosmetic eye whitening procedure that involves the use of intraoperative and postoperative topical mitomycin C.
Findings: This is a single case report. A 59-year-old Caucasian male with a history of blepharitis status post uncomplicated LASIK refractive surgery reported chronic conjunctival hyperemia for 15 years prior to undergoing a cosmetic eye whitening procedure. He presented to our clinic 12 months after the cosmetic eye whitening procedure with progressive bilateral necrotizing scleritis and scleral calcification.
Conclusions
Chronic conjunctival hyperemia may prompt patients to seek surgical correction with cosmetic eye whitening procedures. However, conjunctival hyperemia secondary to tear deficiency and evaporative dry eye may predispose to poor wound healing. Serious complications including necrotizing scleritis may result from cosmetic eye whitening procedures and the use of topical mitomycin C.
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ReplyDeleteScleritis may occur as a result of various stimuli, the most famous of which is rheumatoid arthritis. But many of the so called connective tissue diseases or collagen vascular diseases may have scleritis as part of their disease spectrum. Indeed, inflammation of the sclera can sometimes be a presenting manifestation of a potentially very serious systemic disease. Sometimes inflammation in the eye will precede extraocular (outside the eye) manifestations of a serious systemic disease by many months or even a few years. This is but one of the many reasons why it is so critical for patients to regularly visit with a physician trained in ophthalmology: an ophthalmologist.