Iatrogenic conjunctival entrapment of cilium and scleral ulceration after subtenon steroid injection.

PURPOSE: To report the presence of an asymptomatic cilium in the subconjunctival area and an adjacent sterile scleral ulcer, together as a complication of subtenon injection of steroids, and the resolution of the ulcer despite the in situ cilium.

METHODS

Medical management of a 51-year-old man, who was a known case of ankylosing spondylitis, with a 3-mm scleral ulcer located in the inferior palpebral area with one adjacent fully embedded cilium at the probable site of subtenon injection given for suspected acute iridocyclitis.

RESULTS

On altering the medication, the ulcer resolved completely. This occurred despite the in situ cilium, which did not act as a nidus for infection or inflammation.

CONCLUSIONS

The presence of cilia did not adversely affect the outcome of treatment of the adjacent ulcer. Therefore, if there is no exposure of the entrapped cilium through the conjunctiva, as was in this case, conservative management of the ulcer and not trying to remove the cilium seems to be a good alternative as opposed to reports in literature, which warrant its removal in most cases.