Surgical treatment can be considered in individuals with severe refractory necrotizing scleritis to reinforce the wall in the setting of an impending perforation or to close a spontaneous or traumatic corneal and/or scleral defect (tectonic grafting). Figure 7-10 shows a postoperative aspect of scleral grafting. Cadaveric donor sclera may be used for grafting, but it can melt. Consequently, some authors have recommended use of autogenous periosteum or donor cornea. In cases of infectious scleritis, scleral debridement can be considered in addition to antibiotics.
Excerpted from BCSC 2020-2021 series: Section 9 - Uveitis and Ocular Inflammation. For more information and to purchase the entire series, please visit https://www.aao.org/bcsc.