Scleromalacia perforans

Patients may not be compliant with drug therapy due to side effects, the need for follow-up visits, and a lack of perceived need. Thorough patient education is critical. The 5-year mortality rate associated with scleromalacia perforans is as high as 73% therefore appropriate and timely referral and comanagement with the appropriate medical specialist is important in minimizing mortality. 

Lesion color and examination lighting can play a crucial role in scleritis evaluation. For example, red-free light can be used to enhance blood vessels and may allow the clinician to observe areas of vascular closure (Figure 28-6) within a scleritis lesion. These areas represent vascular occlusion and destruction from progressive infiltrative inflammation. Except in scleromalacia perforans, anterior scleritis creates a characteristic bluish red or purplish (violaceous) color in contrast to the salmon red or bright red injection observed in episcleritis. This violaceous... 

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