Scleral Thinning

• Topical antimetabolites such as mitomycin-C or triethylene thiophosphamide have been routinely used as an adjunctive therapy after pterygium removal surgery to decrease the likelihood of recurrency.
• May be complicated with corneal or scleral thinning, ulceration and necrosis especially when bare scleral technique is applied.

Clinical Features

• Symptoms: may be asymptomatic or associated with ocular irritation
• Signs:
• Scleral thinning with trans-sclerally visible choroid
• Hyperemia of the overlying conjunctiva
• May progress to scleral perforation

Management

• Observation, if asymptomatic and no evidence of perforation.
• Surgical patch grafts to reinforce the thinning sclera.