Pt of bl scleral thinning wd uveal ts prolapse no Ho ptergium excision or mmc use seeing d ot fr d last 10 yrs earlier it vs thinning only . Wts d treat modalies vn deterioring gn normal nothing abnormal otherwise

Perforation is beyond the limbus. So it is from scleral thinning most probably from autoimmune cause(collagen disease) . As the eye is white and quiet it looks like scleral melting. Also rule out wagners( unlikely in this case) .Agree with Dr Gajjar it being sleromalacia perforans. Full systemic investigation on line of collagen disease. Needs scleral graft on emergency basis
Is it bil moorens. Bt eye appears quiet. No surgical history? Pln fr scleral patch graft
Mooren's ulcer occurs on peripheral cornea .
Scleromalacia perforance .
History of joint pain's?? Serological tests are mandatory to rule out autoimmune diseases,surgical treatment includes patch graft with amniotic membrane, and topical steroids, but before surgical intervention, please try IV cyclophosphamide once a month for 3 months and observe regression, monitor blood cells count regularly
Please , tell the diagnosis .

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Thank you Dr Gajjar! Your diagnosis is right.Necrotizing nodular scleritis eventually leads to scleromalacia perforans.This rare affection needs also to be differentiated from tuberculoma and spontaneous intercalary perforation.
Also thank u for other 2 d d .
It looks like an OSSN.How do you suggest in a subject of 46 yrs having unilateral lesion to be a case of limbal type of VKC?Biopsy and its report will be needed to guide the management.
It doesn't seem to be rheumatological or scleromalacia!The most important thing is the location,shape and size of the thinning which absolutely corresponds with the pterygium bed!
Most like Diag is scleromalcia perforance only . On next visit rpt investigations ll b done to rule out collagen disorders though an yr back all tests vr neg
This seems to be a post mitomycin scleral melt which needs an urgent intervention like scleral patch grafting or a multilayered AMG!
Perhaps I am not right! Most probably Dr Gajjar's diagnosis is accurate-scleromalacia perforans0
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