We report an unusual case of scleral and lid necrosis from suspected self-harm and the management of the resultant scleral perforation with a tarsoconjunctival ‘Hughes’ flap. To our knowledge, no previous literature describes such a technique in the repair of toxic scleral melts. Our case describes an alternative use for a Hughes flap in providing tectonic support and helping to restore the integrity of the globe in a complex case where conventional methods of ‘patching’ had failed.
ComacchioFRiccaMMartiniG, et al. Ocular nonsuicidal self-injury in a teenager. Oman J Ophthalmol2018; 11(1): 55–57.
7.
LuLXuSGeS, et al. Tailored treatment for the management of scleral necrosis following pterygium excision. Exp Ther Med2017; 13(3): 845–850.
8.
SangwanVSJainVGuptaP. Structural and functional outcome of scleral patch graft. Eye (Lond)2007; 21: 930–935.
9.
BeardsleyRMSuhlerEBRosenbaumJT, et al. Pharma-cotherapy of scleritis: current paradigms and future directions. Expert Opin Pharmacother2013; 14(4): 411–424.
10.
MaDHWangSFSuWY, et al. Amniotic membrane graft for the management of scleral melting and corneal perforation in recalcitrant infectious scleral and corneoscleral ulcers. Cornea2002; 21(3): 275–283.
11.
CasasVEKheirkhahABlancoG, et al. Surgical approach for scleral ischemia and melt. Invest Ophthalmol Vis Sci2007; 48(13): 359.
