How is infectious scleritis diagnosed?

Updated: Aug 29, 2019
  • Author: Manolette R Roque, MD, MBA, FPAO; Chief Editor: Andrew A Dahl, MD, FACS  more...
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Answer

See the list below:

  • Smears, cultures, and polymerase chain reaction (PCR) from conjunctival, corneal, episcleral, or scleral scraping - Infectious scleritis

    • Scleral or corneoscleral biopsy is recommended if smears and culture results are negative at 48 hours, infectious scleritis is still the primary clinical suspicion, and the patient is worsening despite targeted empirical antimicrobial therapy.

      • One third of tissue from a biopsy is sent to the microbiology department, where it is homogenized for smears, cultures, and PCR.

      • The middle third of tissue is transported to the pathology department for histopathology with special stains (eg, periodic acid-Schiff [PAS], Gomori methenamine-silver [GMS], acid-fast, calcofluor white).

      • The last third of tissue is sent to the immunology department for immunofluorescence studies with monoclonal antibodies (eg, anti–herpes simplex virus type 1, anti–varicella-zoster virus antibodies).

  • PCR of body fluids, orbital abscess drainage, aqueous humor, and vitreous - Infectious scleritis


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