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Dr. A.S. Desai
Dr. A.S. Desai, Ophthalmologist
Category: Eye
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Experience:  MS Ophthalmology with 13 years of surgical expereince
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My wife had a tumor removed from behind her left eye and 5

Resolved Question:

My wife had a tumor removed from behind her left eye and 5 years later developed Nodular Scleritis - Is this curable
Submitted: 5 years ago.
Category: Eye
Expert:  Dr. A.S. Desai replied 5 years ago.

Dr. A.S. Desai :

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Dr. A.S. Desai :

Are you aware of the diagnosis of the tumour removed from behind the eye?

Dr. A.S. Desai :

Is it an ophthalmologist who has made the diagnosis of nodular scleritis now?


Yes Dr Louis Kruger

Dr. A.S. Desai :

There can be many causes for nodular scleritis and more often from autoimmune diseases.

Dr. A.S. Desai :

I guess the diagnosis has been made after a thorough work up of the eye. As you must be aware that more often than not, the underlying cause is an autoimmune condition( rheumatoid arthritis/wegener's granulomatosis/polyarteritis nodosa/gout/rosacea etc). The treatment can have varied results and the usual protocol followed in the treatment of nodular scleritis is- first line of treatment is NSAIDs or oral steroids( if severe). Oral prednisolone can be given in calculated divided doses( 1mg/kg/day in divided doses). If found to be responsive , maintainence can be done with NSAIDs. In those who do not tolerate steroids, immunosuppressants such as methotrexate can be given. But treatment of scleritis can be quite frustating as far as the results are concerned.

Dr. A.S. Desai :

In those cases which show signs of severe scleral thinning or impending perforation, a scleral graft can be tried.

Dr. A.S. Desai :

To summarise, nodular scleritis is curable provided the individual tolerates well to steroids or immunosuppressants. Many a times the treatment is discontinued due to severe side effects of steroids/immunosuppressants.

Dr. A.S. Desai :

I hope this addresses your concerns.

Dr. A.S. Desai :

Please feel free to ask follow up questions , if any.

Dr. A.S. Desai :

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Views expressed are for information purpose only and cannot substitute a visit to an ophthalmologist

Dr. A.S. Desai and other Eye Specialists are ready to help you
Customer: replied 5 years ago.
Hello Dr Desai.
My wife's Opthalmic surgeon injected an anaesthetic behind the eye to try to reduce the swelling and get the pain threshold down, this helped for a few hours but the pain was more intense when the anaesthetic wore off.
He is concerned about using certain drugs due to the long term side affects. He has now prescribed Pred Forte 5ml drops 4 hourly for 4 days then 2 days off repeated for a month. She also takes Tenston SA for pain (3-4 tablets in a 24 hour period)
Thank you for your on-going concern.
Could you please advise which country you are practicing in as we would consider flying overseas if this would give my wife permenant relief after her suffering 24 hours a day for the last 2 and a half years .
Many Thanks
Expert:  Dr. A.S. Desai replied 5 years ago.

I truly sympathesize with your wife's agony and suffering .I understand the doctor's concern about using oral steroids due its severe long term effects, which is why he has continued with topical steroids.But literature and clinical experience does mention the inadequency of topical steroids in controlling the inflammation. For expert advise you can consult an immunologist who can work up in detail and then suggest which line of therapy would help - oral steroids or immunosuppressants.

I'm located in India, Bangalore , where we do have good eye care facilities but with utter modesty I would say that it would not be worth the journey more so because the condition itself is so refractory that even the best of doctors can find it very frustrating to treat.

I'm sure your wife is in good hands and the doctor is perhaps weighing the consequences of starting oral treatment with steroids or immunosuppressants.

Perhaps you could read a bit more about this condition out of interest, following this link-

Thank you and best wishes

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