Scleromalacia perforans is a rare form of anterior scleritis represented by progressive thinning of the sclera.
It is a rare, severe eye disorder developing an autoimmune damage of episcleral and scleral performing vessels.
It is a type III hypersensitivity reaction which occurs due to accumulation of immune complexes.
The onset is gradual. Most patients complains of non-specific irritation. Pain is generally absent and vision is unaffected. The change in scleral color is often detected by patient’s family, by patient looking in the mirror or by an ophthalmologist during routine examination.
Necrotic scleral plaques near the limbus without vascular congestion. Coalescence and enlargement of necrotic areas. The sclera thins and the underlying dark uveal tissue becomes visible.
Autoimmune connective tissue disorders like rheumatoid arthritis, lupus, sero-negative spondylarthropathies , granulomatosis with polyangiitis and polyarteritis nodosa should be ruled out.
There is no specific therapy . Protection from trauma is important.