Evaluation of eyes enucleated for scleritis

Of all ocular diseases few are more painful or serious than scleritis but, as it is a fairly rare disease, most ophthalmologists have relatively little experience in its diagnosis and management. For the past io years Moorfields Eye Hospital has held a weekly scleritis clinic in the hope that the data obtained might further the understanding of this disease. A review of 207 patients with scleritis shows that 27 per cent of those with necrotizing scleritis died from an associated systemic disease within five years of the onset of the ocular inflammation (Watson and Hayreh, 1976). Method and material It was therefore important to discover why eyes with scleritis had been removed, and, if treatment had been given, why it had failed. A io-year retrospective study of enucleated eyes in which a principal histologic diagnosis of scleritis had been made was undertaken. Altogether 30 eyes which fulfilled these criteria were sent from hospitals in all parts of Great Britain to the Department of Pathology, Institute of Ophthalmology, London, from January 1965 to January 1975. Each patient's record was sent to the authors for review, or a questionnaire was com-pleted by the surgeon who had removed the eye. The data giving details of treatment were incomplete in five cases and these have been excluded from Table IV. A similar review was undertaken by Sevel (i967) Io years ago. This present study is of the same geo-graphical area but it does not include any of Sevel's cases. Classification Clinically, several types of scleritis can be distin-guished: ANTERIOR SCLERITIS A diffuse, nodular, necrotizing scleritis with surrounding inflammation, or necrotizing without surrounding inflammation (scleromalacia perforans)