The Sclera pp 95-136 | Cite as

Clinical Considerations of Episcleritis and Scleritis: The Massachusetts Eye and Ear Infirmary Experience

  • C. Stephen Foster
  • Maite Sainz de la Maza


Because episcleritis and scleritis are entities encountered infrequently in general ophthalmic practice, the diagnosis and subsequent treatment may be missed or delayed because of the relative lack of experience in their detection and management. Fraunfelder and Watsonl reported that in a series of 30 enucleated eyes (sent from hospitals from all parts of Great Britain) with a primary histological diagnosis of scleritis, the clinical diagnosis of scleritis had been missed in 12 (40%), often because the scleritis was masked by multiple complications such as uveitis, glaucoma, and keratolysis. Many of these 12 eyes had not received antiinflammatory treatment and many of the 18 eyes affected by clinical scleritis had received insufficient antiinflammatory treatment. The main reason for enucleation was pain with loss of vision. Many of these patients had had the ocular inflammation for up to 30 years before the enucleation.


Macular Edema Anterior Uveitis Peripheral Corneal Color Insert Posterior Scleritis 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Fraunfelder FT, Watson PG: Evaluation of eyes enucleated for scleritis. Br J Ophthal 60: 227, 1976.Google Scholar
  2. 2.
    Watson PG, Hayreh SS: Scleritis and episcleritis. Br J Ophthalmol 60: 163, 1976.PubMedGoogle Scholar
  3. 3.
    Watson PG, Hazleman BL: The Sclera and Systemic Disorders. W.B. Saunders, Philadelphia, 1976.Google Scholar
  4. 4.
    Watson PG: Doyne Memorial Lecture, 1982. The nature and the treatment of scleral inflammation. Trans Ophthalmol Soc UK 102: 257, 1982.PubMedGoogle Scholar
  5. 5.
    Watson PG: Diseases of the sclera and episclera. In Tasman W, Jaeger EA (Eds): Duane’s Clinical Ophthalmology, rev ed. Lippincott, Philadelphia, 1992, pp 1–43.Google Scholar
  6. 6.
    Wilhelmus KR, Watson PG, Vasavada AR: Uveitis associated with scleritis. Trans Ophthalmol Soc UK 101: 351, 1981.PubMedGoogle Scholar
  7. 7.
    Calthorpe CM, Watson PG, McCartney ACE: Posterior scleritis: a clinical and histopathological survey. Eye 2: 267, 1988.PubMedGoogle Scholar
  8. 8.
    Cleary PE, Watson PG: Visual loss due to posterior segment disease in scleritis. Trans Ophthalmol Soc UK 95: 297, 1975.PubMedGoogle Scholar
  9. 9.
    Wilhelmus KR, Grierson I, Watson PG: Histopathologic and clinical associations of scleritis and glaucoma. Am J Ophthalmol 91: 697, 1981.PubMedGoogle Scholar
  10. 10.
    Lyons CJ, Hakin KN, Watson PG: Topical Flurbiprofen: an effective treatment for episcleritis? Eye 4: 521, 1990.PubMedGoogle Scholar
  11. 11.
    Meyer PA, Watson PG, Franks W, Dubord P: “Pulsed” immunosuppressive therapy in the treatment of immunologically induced corneal and scleral disease. Eye 1: 487, 1987.PubMedGoogle Scholar
  12. 12.
    Hayreh SS, Watson PG: Prednisolone-21stearoylglycolate in scleritis. Br J Ophthalmol 54: 394, 1970.PubMedGoogle Scholar
  13. 13.
    Tuft SJ, Watson PG: Progression of scleral disease. Ophthalmology 98: 467, 1991.PubMedGoogle Scholar
  14. 14.
    Williamson J: Incidence of eye disease in cases of connective tissue disease. Trans Ophthal Soc UK 94: 742, 1974.PubMedGoogle Scholar
  15. 15.
    Heinonen O: Über Episcleritis periodica fugax and Erblichkeit. Acta Ophthalmologica 1: 166, 1923.Google Scholar
  16. 16.
    Heinonen O: Nachtrag zu meiner Arbeit “Über episcleritis periodica fugax and Erblichkeit.” Acta Ophthalmologica, 4: 278, 1927.Google Scholar
  17. 17.
    Lyne AJ, Pitkeathley DA: Episcleritis and scleritis. Arch Ophthalmol 80: 171, 1968.PubMedGoogle Scholar
  18. 18.
    McGavin DD, Williamson J, Forrester JV, Foulds WS: Episcleritis and scleritis: a study of their clinical manifestations and association with rheumatoid arthritis. Br J Ophthalmol 60: 192, 1976.PubMedGoogle Scholar
  19. 19.
    Watson PG, McKay DA, Clemett RS, Wilkinson P: Treatment of episcleritis. A double blind trial comparing betamethasone 0.1%, oxyphenbutazone 10% and placebo eye ointments. Br J Ophthalmol 57: 866, 1973.PubMedGoogle Scholar
  20. 20.
    Campbell DM: Episcleritis. Ophthalmic Rec 12: 517, 1903.Google Scholar
  21. 21.
    Duke-Elder S, Leigh AG: Diseases of the outer eye. Cornea and sclera. In Duke-Elder S (Ed): System of Ophthalmology, Vol 8, Part 2. C.V. Mosby, St. Louis, 1965, p 108.Google Scholar
  22. 22.
    James DG: Erythema nodosum. Br Med J 1: 853, 1961.PubMedGoogle Scholar
  23. 23.
    Beerman H: Erythema nodosum. Am J Med Sci 223: 433, 1952.PubMedGoogle Scholar
  24. 24.
    McCarthy JL: Episcleral nodules and erythema nodosum. Am J Ophthalmol 51: 60, 1961.PubMedGoogle Scholar
  25. 25.
    Friedman AH, Henkind P: Unusual causes of episcleritis. Trans Am Acad Ophthalmol Otolaryngol 71: 303, 1967.Google Scholar
  26. 26.
    Margo CE: Recurrent episcleritis and emotional stress. Arch Ophthalmol 102: 821, 1984.PubMedGoogle Scholar
  27. 27.
    Rahe RH: Subjects’ recent life changes and their near-future illness susceptibility. Adv Psychosom Med 8: 2, 1972.PubMedGoogle Scholar
  28. 28.
    Obermayer M: Psychocutaneous Medicine. Charles C Thomas, Springfield IL, 1955.Google Scholar
  29. 29.
    Weiner H, Thaler M, Reiser MF: Etiology of duodenal ulcer. Psychosom Med 19: 1, 1957.PubMedGoogle Scholar
  30. 30.
    Engel GL: Studies of ulcerative colitis. III. The nature of the psychology process. Am J Med 19: 231, 1955.PubMedGoogle Scholar
  31. 31.
    Rothfield N: Clinical features of systemic lupus erythematosus. In Kelley WN, Harris ED, Ruddy S, Sledge CB (Eds): Textbook of Rheumatology, 3rd ed. W.B. Saunders, Philadelphia, 1989, pp 1070–1093.Google Scholar
  32. 32.
    Palmblad J: Stress and immunologic competence: studies in man. In Ader R (Ed): Psychoneuroimmunology. Academic Press, New York, 1981, pp 229–257.Google Scholar
  33. 33.
    Ader R: A historical account of conditioned immunobiologic responses. In Ader R (Ed): Psychoneuroimmunology. Academic Press, New York, 1981, pp 323–345.Google Scholar
  34. 34.
    Benedict WL: Etiology and treatment of scleritis and episcleritis. Trans Am Acad Ophthalmol Otolaryngol 29: 211, 1924.Google Scholar
  35. 35.
    Moench LM: Gynaecologic foci in relation to scleritis and episcleritis and other ocular infections. Am J Med Sci 174: 439, 1927.Google Scholar
  36. 36.
    Villard E: Episclérite cataméniale. Arch d’Ophtalmol 47: 534, 1930.Google Scholar
  37. 37.
    Paufique L, Etienne R: L’étiologie génitale de quelques affections oculaires chez la femme. Arch d’Ophtalmol 9: 157, 1949.Google Scholar
  38. 38.
    Drouet P, Thomas C: Episclérite periodique et système endocrino-vegatif. Bull Soc d’Ophtalmol France 7: 682, 1952.Google Scholar
  39. 39.
    Zondek B, Bromberg YM: Endocrine allergy. Clinical reactions of allergy to endogenous hormones and their treatment. J Obstet Gynaecol Br Emp 54: 1, 1947.PubMedGoogle Scholar
  40. 40.
    Balyeat RM: Scleritis due to allergy. J Am Med Assoc 98: 2054, 1932.Google Scholar
  41. 41.
    Sinskey HL, Levin MB, Sacks B: Episcleritisa new method of approach. Arch Ophthalmol 50: 526, 1921.Google Scholar
  42. 42.
    Shoemaker WA: Episcleritis. Am J Ophthalmol 7: 468, 1924.Google Scholar
  43. 43.
    Watson PG: The diagnosis and management of scleritis. Ophthalmology 87: 716, 1980.PubMedGoogle Scholar
  44. 44.
    Sainz de la Maza M, Tauber J, Foster CS: Scleral grafting for necrotizing scleritis. Ophthalmology 96: 306, 1989.Google Scholar
  45. 45.
    Foster CS, Forstot SL, Wilson LA: Mortality rate in rheumatoid arthritis patients developing necrotizing scleritis or peripheral ulcerative keratitis. Ophthalmology 91: 1253, 1984.PubMedGoogle Scholar
  46. 46.
    Scott DGI, Bacon PA, Tribe CR: Systemic rheumatoid vasculitis: a clinical and laboratory study of 50 cases. Medicine 60: 288, 1981.PubMedGoogle Scholar
  47. 47.
    Scott DGI, Bacon PA, Allen C, Parker C: IgG rheumatoid factor, complement, and immune complexes in rheumatoid synovitis and vasculitis: comparative and serial studies during cytotoxic therapy. Clin Exp Immunol 43: 54, 1981.PubMedGoogle Scholar
  48. 48.
    Sokoloff L, Bunim JJ: Vascular lesions in rheumatoid arthritis. J Chronic Dis 5: 668, 1957.PubMedGoogle Scholar
  49. 49.
    Douglas W: The digital artery lesion of rheumatoid arthritis. Ann Rheum Dis 24: 40, 1965.PubMedGoogle Scholar
  50. 50.
    Ferguson RH, Slocumb CH: Peripheral neuropathy in rheumatoid arthritis. Bull Rheum Dis 11: 251, 1961.PubMedGoogle Scholar
  51. 51.
    Hunder GG, McDuffie FC: Hypocomplementemia in rheumatoid arthritis. Am J Med 54: 461, 1973.PubMedGoogle Scholar
  52. 52.
    Collins DH: The subcutaneous nodule of rheumatoid arthritis. J Pathol Bacteriol 45: 97, 1937.Google Scholar
  53. 53.
    Bennett GA, Zeller JW, Bauer W: Subcutaneous nodules of rheumatoid arthritis and rheumatic fever: a pathologic study. Arch Pathol 30: 70, 1940.Google Scholar
  54. 54.
    Kaye BR, Kaye RL, Bobrove A: Rheumatoid nodules. Review of the spectrum of associated conditions and proposal of a new classification, with a report of four seronegative cases. Am Rheum Dis 23: 345, 1964.Google Scholar
  55. 55.
    Fong LP, Sainz de la Maza M, Rice BA, Foster CS: Immunopathology of scleritis. Ophthalmology 98: 472, 1991.PubMedGoogle Scholar
  56. 56.
    van der Hoeve J: Scleromalacia perforans. Ned T Geneesk 75: 4733, 1931.Google Scholar
  57. 57.
    Roca PD: Necrotising (rheumatoid) disease of the sclera. NY St J Med 74: 1982, 1974.Google Scholar
  58. 58.
    van der Hoeve J: Scleromalacia perforans. Arch Ophthalmol 11: 111, 1934.Google Scholar
  59. 59.
    Wojno Z: Ein Fall von forschreitender Erweichung der Lederhaut. Klin Oczna 13: 778, 1935.Google Scholar
  60. 60.
    Kiehle FA: Scleromalacia. Am J Ophthalmol 20: 565, 1937.Google Scholar
  61. 61.
    Urrets Zavalia A, Maldonado AI, Obregon OR: Skeromalazie in Verlauf einer chronischen Prophyrinurie. Klin Monatsbl Augenheilk 99: 189, 1937.Google Scholar
  62. 62.
    Verhoeff FH, King MJ: Scleromalacia perforans. Report of a case in which the eye was examined microscopically. Arch Ophthalmol 20: 1013, 1938.Google Scholar
  63. 63.
    Franceschetti A, Bischler V: La sclérite nodulaire nécrosante et ses rapports avec la scléromalacie. Ann Ocul 183: 737, 1950.Google Scholar
  64. 64.
    François J: Scléromalacie perforante. Bull Soc Belge d’Ophthalmol 96: 694, 1950.Google Scholar
  65. 65.
    Ashton N, Hobbs HE: Effect of cortisone on rheumatoid nodules of the sclera (scleromalacia perforans). Br J Ophthalmol 36: 373, 1952.PubMedGoogle Scholar
  66. 66.
    Rosenthal JW, Williams GT: Scleromalacia perforans as a complication of rheumatoid arthritis. Am J Ophthalmol 54: 862, 1962.PubMedGoogle Scholar
  67. 67.
    Anderson B, Margolis C: Scleromalacia: clinical and pathologic study of a case with consideration of differential diagnosis, relationship of collagen disease, and effect of ACTH and cortisone therapy. Am J Ophthalmol 35: 917, 1952.PubMedGoogle Scholar
  68. 68.
    Arkle JS, Ingram HV: Scleromalacia perforans. Trans Ophthalmol Soc UK 55: 552, 1935.Google Scholar
  69. 69.
    François J: Scleromalacia perforans, arthritis deformans and pemphigus. Trans Ophthalmol Soc UK 71: 61, 1951.Google Scholar
  70. 70.
    Sorensen TB: Paralimbal scleromalacia. Acta Ophthalmol 53: 901, 1975.Google Scholar
  71. 71.
    Mader TH, Stulting RD, Crosswell HH: Bilateral paralimbal scleromalacia perforans. Am J Ophthalmol 109: 233, 1990.PubMedGoogle Scholar
  72. 72.
    Sena JA, Cereboni FC: Scleral excavations. Arch Oftalmol Buenos Aires, 23: 313, 1948.Google Scholar
  73. 73.
    Kyrieleis W: Ueber umschriebenen Lederhautschwund (Sleromalazie) in hoeheren Lebensalter. Klin Monatsbl Augenheilk 103: 441, 1939.Google Scholar
  74. 74.
    Kiss J: Fall von seniler Sklerverdunnung. Klin Monatsbl Augenheilk 92: 121, 1934.Google Scholar
  75. 75.
    Roper KL: Senile hyaline scleral plaques. Arch Ophthalmol 34: 283, 1945.Google Scholar
  76. 76.
    Graves B: Bilateral mesial superficial deficiency of the sclera: scleral plaques. Br J Ophthalmol 25: 35, 1941.PubMedGoogle Scholar
  77. 77.
    Katz D: A localized area of calcareous degeneration in the sclera. Arch Ophthalmol 2: 30, 1929.Google Scholar
  78. 78.
    Culler AM: The pathology of scleral plaques; report of 5 cases of degenerative plaques in the sclera mesially, one studied histologically. Br J Ophthalmol 23: 44, 1939.PubMedGoogle Scholar
  79. 79.
    Drescher EP, Henderson JW: Senile hyaline scleral plaques; report of 3 cases. Proc Staff Meet Mayo Clin 24: 334, 1949.PubMedGoogle Scholar
  80. 80.
    Holloway TB, Fry WE: Unsuspected brawny scleritis in a case of retinal detachment with secondary glaucoma. Arch Ophthalmol 6: 36, 1931.Google Scholar
  81. 81.
    Howard GM: Erroneous clinical diagnoses of retinoblastoma and uveal melanoma. Trans Am Acad Ophthalmol Otolaryngol 73: 199, 1969.PubMedGoogle Scholar
  82. 82.
    Feldon SE, Singleman J, Albert DM, Smith TR: Clinical manifestations of brawny scleritis. Am J Ophthalmol 85: 781, 1978.PubMedGoogle Scholar
  83. 83.
    Yeo JH, Jakobiek FA, Iwamoto T, Brown R, Harrison W: Metastatic carcinoma masquerading as scleritis. Ophthalmology 90: 184, 1983.PubMedGoogle Scholar
  84. 84.
    Benson WE, Shields JA, Tasman W, Crandall AS: Posterior scleritis. A cause of diagnostic confusion. Arch Ophthalmol 97: 1482, 1979.PubMedGoogle Scholar
  85. 85.
    Singh G, Guthoff R, Foster CS: Observations on longterm follow-up of posterior scleritis. Am J Ophthalmol 101: 570, 1986.PubMedGoogle Scholar
  86. 86.
    Benson WE: Posterior scleritis. Sury Ophthalmol 32: 297, 1988.Google Scholar
  87. 87.
    Blodi FC, Gass JD: Inflammatory pseudo-tumor of the orbit. Br J Ophthalmol 52: 79, 1968.PubMedGoogle Scholar
  88. 88.
    Rootman J, Nugent R: The classification and management of acute orbital pseudotumors. Ophthalmology 89: 1040, 1982.PubMedGoogle Scholar
  89. 89.
    Cappaert WE, Purnell EW, Frank KE: Use of B-sector scan ultrasound in the diagnosis of benign choroidal folds. Am J Ophthalmol 84: 375, 1977.PubMedGoogle Scholar
  90. 90.
    Kalina RE, Mills RP: Acquired hyperopia with choroidal folds. Ophthalmology 87: 44, 1980.PubMedGoogle Scholar
  91. 91.
    Sears ML: Choroidal and retinal detachments associated with scleritis. Am J Ophthalmol 58: 764, 1964.PubMedGoogle Scholar
  92. 92.
    Bertelsen TI: Acute sclerotenonitis and ocular myositis complicated by papillitis, retinal detachment and glaucoma. Acta Ophthalmol 38: 136, 1960.Google Scholar
  93. 93.
    Gass JDM: Differential Diagnosis of Intraocular Tumors. C. V. Mosby, St. Louis, 1974.Google Scholar
  94. 94.
    Feldon SE, Sigelman J, Albert DM, Smith TR: Clinical manifestations of brawny scleritis. Am J Ophthalmol 85: 781, 1978.PubMedGoogle Scholar
  95. 95.
    Cangemi FE, Trempe CL, Walsh JB: Choroidal folds. Am J Ophthalmol 86: 380, 1978.PubMedGoogle Scholar
  96. 96.
    Newell FW: Choroidal folds. Am J Ophthalmol 75: 930, 1973.PubMedGoogle Scholar
  97. 97.
    Bullock JD, Egbert PR: Experimental choroidal folds. Am J Ophthalmol 78: 618, 1972.Google Scholar
  98. 98.
    Hyavarinen L, Walsh FB: Benign chorioretinal folds. Am J Ophthalmol 70: 14, 1970.Google Scholar
  99. 99.
    Bellows AR, Chylak LT Jr, Hutchinson BT: Choroidal detachment. Clinical manifestation, therapy and mechanism of formation. Ophthalmology 88: 1107, 1981.PubMedGoogle Scholar
  100. 100.
    Quinlan MP, Hitchings RA: Angle-closure glaucoma secondary to posterior scleritis. Br J Ophthalmol 62: 330, 1978.PubMedGoogle Scholar
  101. 101.
    Rochels R, Reis G: Echography in posterior scleritis. Klin Monatsbl Augenheilk 177: 611, 1980.Google Scholar
  102. 102.
    Mauriello JA, Flanagan JC: Management of orbital inflammatory disease. A protocol. Sury Ophthalmol 29: 104, 1984.Google Scholar
  103. 103.
    Trokel SL, Hilal SK: Submillimeter resolution CT scanning of orbital diseases. Ophthalmology 87: 412, 1980.PubMedGoogle Scholar
  104. 104.
    Trokel SL: Computed tomographic scanning of orbital inflammations. Int Ophthalmol Clin 22 (4): 81, 1982.PubMedGoogle Scholar
  105. 105.
    Terner IS, Leopold IH, Eisenberg IJ: The radioactive phosphorus (32P) uptake test in ophthalmology. Arch Ophthalmol 55: 52, 1956.Google Scholar
  106. 106.
    Zakov ZN, Smith TR, Albert DM: False-positive 32P uptake tests. Arch Ophthalmol 96: 2240, 1978.PubMedGoogle Scholar
  107. 107.
    Shields JA: Accuracy and limitations of the 32P test in the diagnosis of ocular tumors: an analysis of 500 cases. Ophthalmology 85: 950, 1978.PubMedGoogle Scholar
  108. 108.
    Norton EWD: A characteristic fluorescein angiographic pattern in choroidal folds. Proc R Soc Med 62: 119, 1969.PubMedGoogle Scholar
  109. 109.
    Kroll AJ, Norton EWD: Regression of choroidal folds. Trans Am Acad Ophthalmol Otolaryngol 74: 515, 1970.PubMedGoogle Scholar
  110. 110.
    Jakobiec FA, Jones IS: Orbital inflammations. In Duane T (Ed): Clinical Ophthalmology, Vol 2. Harper & Row, Hagerstown MD, 1976, pp 1–75.Google Scholar
  111. 111.
    Birch-Hirschfeld A: Zur Diagnostik und Pathologic der Orbital-tumoren. Ber Dtsch Ophthal Ges 32: 127, 1905.Google Scholar
  112. 112.
    Jellinek EH: The orbital pseudotumour syndrome and its differentiation from endocrine exophthalmos. Brain 92: 35, 1969.PubMedGoogle Scholar
  113. 113.
    Chavis RM, Garner A, Wright JE: Inflammatory orbital pseudotumor. Arch Ophthalmol 96: 1817, 1978.PubMedGoogle Scholar
  114. 114.
    Heersink B, Rodrigues MR, Flanagan JC: Inflammatory pseudotumor of the orbit. Ann Ophthalmol 9: 17, 1977.PubMedGoogle Scholar
  115. 115.
    Coleman JD, Jack RL, Jones IS, Frazen LA: Pseudotumors of the orbit. Arch Ophthalmol 88: 472, 1972.PubMedGoogle Scholar
  116. 116.
    Kennerdell JS, Dressner SC: The nonspecific orbital inflammatory syndromes. Sury Ophthalmol 29: 93, 1984.Google Scholar
  117. 117.
    Sergott RC, Glaser JS: Graves’ ophthalmopathy. A clinical and immunologic review. Sury Ophthalmol 26: 1, 1981.Google Scholar
  118. 118.
    Trokel SL, Jakobiec FA: Correlation of CT scanning and pathologic features of ophthalmic Graves’ disease. Ophthalmology 88: 553, 1981.PubMedGoogle Scholar
  119. 119.
    Char DH: Clinical Ocular Oncology. Churchill Livingstone, New York, 1989, pp 97–108.Google Scholar
  120. 120.
    Hallden U: Malignant melanoma of the choroid clinically simulating scleritis attended by amotio retinae. Acta Ophthalmol 33: 489, 1955.Google Scholar
  121. 121.
    Smith LT, Irvine AR: Diagnostic significance of orange pigment accumulation over choroidal tumors. Am J Ophthalmol 76: 212, 1973.PubMedGoogle Scholar
  122. 122.
    Chang S, Dallow RL, Coleman DJ: Ultrasonic evaluation of intraocular tumors. In Jakobiec FA (Ed): Ocular and Anexal Tumors. Aesculapius, Birmingham AL, 1978, pp 290–291.Google Scholar
  123. 123.
    Fraser DJ Jr, Font RL: Ocular inflammation and hemorrhage as initial manifestations of uveal malignant melanoma. Incidence and prognosis. Arch Ophthalmol 97: 1311, 1979.PubMedGoogle Scholar
  124. 124.
    Ferry AP, Font RL: Carcinoma metastatic to the eye and orbit. I. A clinicopathologic study of 227 cases. Arch Ophthalmol 92: 276, 1974.PubMedGoogle Scholar
  125. 125.
    Yeo JH, Jakobiec FA, Iwamoto T, Brown R, Harrison W: Metastatic carcinoma masquerading as scleritis. Ophthalmology 90: 184, 1983.PubMedGoogle Scholar
  126. 126.
    Witschel H, Font RL: Hemangioma of the choroid. A clinicopathologic study of 71 cases and a review of the literature. Sury Ophthalmol 20: 415, 1976.Google Scholar
  127. 127.
    Augsburger JJ, Shields JA, Moffat KP: Circumscribed choroidal hemangiomas: long-term visual prognosis. Retina 1: 56, 1981.PubMedGoogle Scholar
  128. 128.
    Hayreh SS: Choroidal tumors: role of fluorescein fundus angiography in their diagnosis. Curr Concepts Ophthalmol 4: 168, 1974.Google Scholar
  129. 129.
    Gass JDM: Radial chorioretinal folds. A sign of choroidal neovascularization. Arch Ophthalmol 99: 1016, 1981.PubMedGoogle Scholar
  130. 130.
    Nettleship E: Peculiar lines in the choroid in a case of postpapillitic atrophy. Trans Ophthalmol Soc UK 4: 167, 1884.Google Scholar
  131. 131.
    Bird AC, Sanders MD: Choroidal folds in association with papilloedema. Br J Ophthalmol 57: 89, 1973.PubMedGoogle Scholar
  132. 132.
    Gass JDM: Hypotony maculopathy. In Bellows JC (Ed): Comtemporary Ophthalmology, Honoring Sir Stewart Duke-Elder. Williams & Wilkins, Baltimore, 1972, pp 343–366.Google Scholar
  133. 133.
    Collins ET: Intra-ocular tension. I. The sequelae of hypotony. Trans Ophthalmol Soc UK 37: 281, 1917.Google Scholar
  134. 134.
    Kreiger AE, Meyer D, Smith TR, Riemer K: Metastatic carcinoma to the choroid with choroidal detachment. Arch Ophthalmol 82: 209, 1969.PubMedGoogle Scholar
  135. 135.
    Taake WH, Allen RA, Straatsma BR: Metastasis of a hepatoma to the choroid. Am J Ophthalmol 56: 208, 1953.Google Scholar
  136. 136.
    Schepens CL, Brockhurst RJ: Uveal effusion. I. Clinical picture. Arch Ophthalmol 70: 189, 1963.PubMedGoogle Scholar
  137. 137.
    Gass JDM, Jallow S: Idiopathic serous detachment of the choroid, ciliary body, and retina (uveal effusion syndrome). Ophthalmology 89: 1018, 1982.PubMedGoogle Scholar
  138. 138.
    Wilson RS, Hanna C, Morris MD: Idiopathic chorioretinal effusion: an analysis of extra-cellular fluids. Ann Ophthalmol 9: 647, 1977.PubMedGoogle Scholar
  139. 139.
    Ohno S, Char DH, Kimura SJ, O’Connor GR: Vogt-Koyanagi-Harada syndrome. Am J Ophthalmol 83: 735, 1977.PubMedGoogle Scholar
  140. 140.
    Perry HD, Font RL: Clinical and histopathologic observations in severe Vogt-KoyanagiHarada syndrome. Am J Ophthalmol 83: 242, 1977.PubMedGoogle Scholar
  141. 141.
    Pattison EM: Uveomeningoencephalitic syndrome (Vogt-Koyanagi-Harada). Arch Neurol 12: 197, 1965.PubMedGoogle Scholar
  142. 142.
    Lubin JR, Loewenstein JI, Frederick AR: Vogt-Koyanagi-Harada syndrome with focal neurologic signs. Am J Ophthalmol 91: 332, 1981.PubMedGoogle Scholar
  143. 143.
    Holt-Wilson AD, Watson PG: Non-syphilitic deep interstitial keratitis associated with scleritis. Trans Ophthalmol Soc UK 94: 52, 1974.Google Scholar
  144. 144.
    Ferry AP, Leopold IH: Marginal (ring) corneal ulcer as a presenting manifestation of Wegener’s granuloma. Trans Am Acad Ophthalmol Otolaryngol 74: 1276, 1970.PubMedGoogle Scholar
  145. 145.
    Brown SI, Grayson M: Marginal furrows: a characteristic corneal lesion of rheumatoid arthritis. Arch Ophthalmol 79: 563, 1968.PubMedGoogle Scholar
  146. 146.
    Eiferman RA, Carothers DJ, Yankeelov JA: Peripheral rheumatoid ulceration and evidence for conjunctival collagenase production. Am J Ophthalmol 87: 703, 1979.PubMedGoogle Scholar
  147. 147.
    Jayson MIV, Easty DL: Ulceration of the cornea in rheumatoid arthritis. Ann Rheum Dis 36: 428, 1977.PubMedGoogle Scholar
  148. 148.
    Scharf Y, Meyer E, Nahir M, Zonis S: Marginal mottling of cornea in rheumatoid arthritis. Ann Ophthalmol 16: 924, 1984.PubMedGoogle Scholar
  149. 149.
    Lyne AJ: “Contact lens” cornea in rheumatoid arthritis. Br J Ophthalmol 54:410, 1970.Google Scholar
  150. 150.
    Goldman KN, Kaufman HE: Atypical pterygium: a clinical feature of Terrien’s marginal degeneration. Arch Ophthalmol 96: 1027, 1978.PubMedGoogle Scholar
  151. 151.
    Etzine S, Friedmann A: Marginal dystrophy of the cornea with total ectasia. Am J Ophthalmol 55: 150, 1963.Google Scholar
  152. 152.
    Austin P, Brown SI: Inflammatory Terrien’s marginal corneal disease. Am J Ophthalmol 92: 189, 1981.PubMedGoogle Scholar
  153. 153.
    Krachmer JH: Pellucid marginal corneal degeneration. Arch Ophthalmol 96: 1217, 1978.PubMedGoogle Scholar
  154. 154.
    Krachmer JH, Feder RS, Belin MW: Keratoconus and related noninflammatory corneal thinning disorders. Sury Ophthalmol 28: 293, 1984.Google Scholar
  155. 155.
    Friedlander MH, Smolin G: Corneal degenerations. Ann Ophthalmol 11: 1485, 1979.Google Scholar
  156. 156.
    Sugar A: Corneal and conjunctival degenerations. In Kaufman HE, Barron BA, McDonald MB, Waltman SR (Eds): The cornea. Churchill Livingstone, New York, 1988.Google Scholar
  157. 157.
    Tauber J, Sainz de la Maza M, Hoang-Xuan T, Foster CS: An analysis of therapeutic decision making regarding immunosuppressive chemotherapy for peripheral ulcerative keratitis. Cornea 9 (1): 66, 1990.PubMedGoogle Scholar
  158. 158.
    Foster CS: Immunosuppressive therapy for external ocular inflammatory disease. Ophthalmology 87: 140, 1980.PubMedGoogle Scholar
  159. 159.
    Sainz de la Maza M, Foster CS: The diagnosis and treatment of peripheral ulcerative keratitis. Semin Ophthalmol 6 (3): 133, 1991.Google Scholar
  160. 160.
    Foster CS: Systemic immunosuppressive therapy for progressive bilateral Mooren’s ulcer. Ophthalmology 92: 1436, 1985.PubMedGoogle Scholar
  161. 161.
    Sainz de la Maza M, Foster CS: Necrotizing scleritis after ocular surgery: a clinicopathologic study. Ophthalmology 98: 1720, 1991.Google Scholar
  162. 162.
    Lyne AJ, Lloyd-Jones D: Necrotizing scleritis after ocular surgery. Tran Ophthal Soc UK 99: 146, 1979.Google Scholar
  163. 163.
    Salamon SM, Mondino BJ, Zaidman GW: Peripheral corneal ulcers, conjunctival ulcers, and scleritis after cataract surgery. Am J Ophthalmol 93: 334, 1982.PubMedGoogle Scholar
  164. 164.
    Kaufman LM, Folk ER, Miller MT, Tessler HH: Necrotizing scleritis following strabismus surgery for thyroid ophthalmopathy. J Pediatr Ophthalmol Strabismus 26: 236, 1989.PubMedGoogle Scholar
  165. 165.
    Mamalis N, Johnson MD, Haines JM, Teske MP, Olson RJ: Corneal-scleral melt in association with cataract surgery and intraocular lenses: a report of four cases. J Cataract Refract Surg 16: 108, 1990.PubMedGoogle Scholar
  166. 166.
    Bloomfield SE, Becker CG, Christian CL, Nauheim JS: Bilateral necrotising scleritis with marginal corneal ulceration after cataract surgery in a patient with vasculitis. Br J Ophthalmol 64: 170, 1980.PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media New York 1994

Authors and Affiliations

  • C. Stephen Foster
    • 1
  • Maite Sainz de la Maza
    • 2
  1. 1.Harvard Medical School, Immunology and Uveitis ServiceMassachusetts Eye and Ear InfirmaryBostonUSA
  2. 2.Central University of BarcelonaBarcelonaSpain

Personalised recommendations