A man in his 50s was treated for Moraxella-associated infectious scleritis, as reported by BMJ Case Reports authors. The patient presented to the eye emergency department with a painful and red left eye, accompanied by a foreign body sensation and photophobia. The patient’s medical history included a diagnosis of chronic lymphocytic leukaemia in 2020 and recurrent uveitis.
Initial examination revealed that the patient’s right eye had a visual acuity of 6/5, while the left eye was limited to 6/24. The initial diagnosis was acute anterior uveitis, and treatment involved the prescription of steroids and medication to lower intraocular pressure.
However, over the next month, the patient presented to the emergency eye department six times, complaining of worsening symptoms. Upon being referred to the outpatient uveitis clinic, the patient was diagnosed with infectious scleritis with an associated scleral melt. The scleral scrapes grew Moraxella nonliquefaciens.
The patient’s treatment plan involved oral antibiotics and discontinuing the use of steroid drops alongside intraocular pressure-lowering medication. Six weeks after commencing antibiotic treatment, the infection had resolved. However, cataract formation and posterior synechiae limited visual acuity in the left eye to counting fingers.
Infectious scleritis is a rare, sight-threatening condition. It is characterized by inflammation of the sclera, the fibrous white layer that surrounds the eye. Risk factors for infectious scleritis include previous eye surgery, systemic immunosuppression, and ocular surface disease.
Moraxella, a genus of Gram-negative bacteria, is associated with a range of infections, including conjunctivitis and corneal ulcers. Moraxella nonliquefaciens is a species of Moraxella that is rarely associated with infectious scleritis.
Because infectious scleritis is a potentially serious condition, prompt diagnosis and treatment are essential. Treatment options include topical and systemic antibiotics, systemic steroids, and surgical intervention.
In conclusion, the presented case highlights the importance of considering infectious scleritis as a possible diagnosis in patients with a red, painful eye. Early recognition and appropriate treatment can help prevent vision loss and improve outcomes for patients. Additionally, further research is needed to explore the potential role of Moraxella nonliquefaciens in infectious scleritis.
