Scleromalacia Perforans

I. Purpose The purpose of this paper is to present a modification of an existing surgical procedure for the treatment of a severe case of scleromalacia perforans. To our knowledge this modification has not been previously described. II. Background The problem facing us was that of a 40-year-old farmer who presented with a painful right eye with 20/100 vision and a thin, ectatic defect of the temporal bulbar sclera, measuring 9×10 mm., consistent with scleromalacia perforans (Fig. 1). This patient had extensive medical evaluations for possible etiology. No rheumatoid arthritis or other pathology could be definitely diagnosed, although there was a suggestion of histoplasmosis of the lung, by x-ray. On repeated occasions, smears and cultures of the lesion were negative for bacteria and fungus. The eye became steadily more red and painful, and the ectatic area, with blue uveal tissue dramatically showing through, became progressively larger (10×14 mm. preoperatively),