Abstract

To report a case of migratory necrotizing scleritis proceding to bleb related endophthalmitis and its successful management.
70 year old female with underlying rheumatoid arthritis and history of phacotrab with MMC 2 years back presented with redness and pain of left eye of 2 months duration. Slit lamp examination revealed a raised scleral nodule superiorly nasal to the limbus with surrounding area of scleral inflammation and thinning . Patient was started on oral corticosteroid, oral Ibuprofen and topical prednisolone . There was subsidence of the inflammation at the initial site however a pus filled nodule appeared at a different site . 2 months later patient presented with thinning at the bleb area with Exudates in anterior chamber and vitreous .Intravitrial antibiotics were given and scleral patch was applied at the bleb area. Patient was started on oral methotrexate 10 mg weekly following which patient showed improvement.