{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T05:40:28Z","timestamp":1756359628688,"version":"3.44.0"},"reference-count":42,"publisher":"BMJ","issue":"12","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2022,11,30]]},"published-print":{"date-parts":[[2022,12]]},"abstract":"<jats:p>A male patient in his 70s presented with left eye necrotising scleritis. His ocular history was significant for pterygium excision with mitomycin C 3\u2009months prior in the affected eye, open-angle glaucoma, nuclear sclerosis cataract and previous sixth cranial nerve palsy. Scleral culture was negative and blood work was positive for rheumatoid factor and HLA-B27. The patient was treated for necrotising scleritis with oral doxycycline, vitamin C, ranitidine and prednisone with gradual taper over 45 days. Two months after initiating treatment, his necrotising scleritis achieved complete resolution; however, a new-onset ocular surface squamous neoplasia (OSSN) was identified at the temporal limbus of the contralateral eye. He was treated with topical interferon alpha-2b 1\u2009million IU qid and achieved complete resolution after 4\u2009months. The case highlights both the acute precipitation of OSSN following oral steroids and a sight-threatening complication following pterygium excision.<\/jats:p>","DOI":"10.1136\/bcr-2022-253300","type":"journal-article","created":{"date-parts":[[2022,12,15]],"date-time":"2022-12-15T09:46:34Z","timestamp":1671097594000},"page":"e253300","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Ocular surface squamous neoplasia in a patient following oral steroids for contralateral necrotising scleritis"],"prefix":"10.1136","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9402-733X","authenticated-orcid":false,"given":"Grace","family":"Yin","sequence":"first","affiliation":[{"name":"Department of Public and Primary Care, University of Cambridge School of Clinical Medicine, Cambridge, UK"},{"name":"Queen's University School of Medicine, Kingston, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shai","family":"Gendler","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joshua","family":"Teichman","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada"},{"name":"Trillium Health Partners, Mississauga, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2022,12,15]]},"reference":[{"key":"2025082721594607000_15.12.e253300.1","unstructured":"Jackson TL . Moorfields manual of ophthalmology \/ Timothy L. Jackson. Philadelphia, Pennsylvania: Mosby, 2008."},{"key":"2025082721594607000_15.12.e253300.2","doi-asserted-by":"publisher","DOI":"10.1136\/bjo.84.3.289"},{"key":"2025082721594607000_15.12.e253300.3","doi-asserted-by":"publisher","DOI":"10.1001\/archopht.119.12.1827"},{"key":"2025082721594607000_15.12.e253300.4","doi-asserted-by":"publisher","DOI":"10.1001\/archopht.1967.00980030487014"},{"key":"2025082721594607000_15.12.e253300.5","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9394(00)00703-0"},{"key":"2025082721594607000_15.12.e253300.6","doi-asserted-by":"publisher","DOI":"10.1136\/bjo.2006.095018"},{"key":"2025082721594607000_15.12.e253300.7","doi-asserted-by":"publisher","DOI":"10.1016\/S1542-0124(12)70103-9"},{"key":"2025082721594607000_15.12.e253300.8","doi-asserted-by":"publisher","DOI":"10.1097\/ICU.0b013e3281a7ecbb"},{"key":"2025082721594607000_15.12.e253300.9","doi-asserted-by":"crossref","first-page":"833","DOI":"10.2147\/OPTH.S155631","article-title":"Impact of conjunctival autograft on pterygium treatment: evaluation of related symptoms and patients' satisfaction after surgery","volume":"12","author":"Wanzeler","year":"2018","journal-title":"Clinical ophthalmology"},{"key":"2025082721594607000_15.12.e253300.10","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9394(14)72602-9"},{"key":"2025082721594607000_15.12.e253300.11","doi-asserted-by":"crossref","first-page":"89","DOI":"10.4103\/njo.njo_5_18","article-title":"Pterygium: recent trends and perspectives\u2014A review of pathogenesis and current management options","volume":"26","author":"Ginger-Eke","year":"2018","journal-title":"Nigerian Journal of Ophthalmology"},{"key":"2025082721594607000_15.12.e253300.12","doi-asserted-by":"crossref","first-page":"661","DOI":"10.1136\/bjo.82.6.661","article-title":"Meta-Analysis on the recurrence rates after bare sclera resection with and without mitomycin C use and conjunctival autograft placement in surgery for primary pterygium","volume":"82","author":"S\u00e1nchez-Thorin","year":"1998","journal-title":"Br J Ophthalmol"},{"key":"2025082721594607000_15.12.e253300.13","unstructured":"Shields JA , Shields CL . Eyelid, conjunctival, and orbital tumors: an atlas and textbook. Kluwer Academic, 2015."},{"key":"2025082721594607000_15.12.e253300.14","doi-asserted-by":"publisher","DOI":"10.1016\/S0039-6257(05)80054-2"},{"key":"2025082721594607000_15.12.e253300.15","unstructured":"Gurnani B , Kaur K . Ocular surface squamous neoplasia. Treasure Island (FL): StatPearls Publishing Copyright \u00a9 2022, StatPearls Publishing LLC, 2022."},{"key":"2025082721594607000_15.12.e253300.16","doi-asserted-by":"crossref","first-page":"1","DOI":"10.4102\/aveh.v79i1.553","article-title":"Ocular surface squamous neoplasia: population demographics, pathogenesis and risk factors","volume":"79","author":"Hollhumer","year":"2020","journal-title":"African Vision and Eye Health"},{"key":"2025082721594607000_15.12.e253300.17","doi-asserted-by":"crossref","first-page":"1562","DOI":"10.1038\/s41433-021-01422-3","article-title":"Ocular surface squamous neoplasia: management and outcomes","volume":"35","author":"H\u04e7llhumer","year":"2021","journal-title":"Eye"},{"key":"2025082721594607000_15.12.e253300.18","doi-asserted-by":"publisher","DOI":"10.1001\/archophthalmol.2011.385"},{"key":"2025082721594607000_15.12.e253300.19","doi-asserted-by":"publisher","DOI":"10.1016\/j.ophtha.2012.03.045"},{"key":"2025082721594607000_15.12.e253300.20","doi-asserted-by":"publisher","DOI":"10.1016\/j.ophtha.2011.04.001"},{"key":"2025082721594607000_15.12.e253300.21","doi-asserted-by":"publisher","DOI":"10.1111\/tmi.12203"},{"key":"2025082721594607000_15.12.e253300.22","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajo.2009.07.026"},{"key":"2025082721594607000_15.12.e253300.23","doi-asserted-by":"crossref","first-page":"620","DOI":"10.1177\/11206721211007109","article-title":"Bilateral ocular surface squamous neoplasia: a study of 25 patients and review of literature","volume":"32","author":"Vempuluru","year":"2022","journal-title":"Eur J Ophthalmol"},{"key":"2025082721594607000_15.12.e253300.24","doi-asserted-by":"publisher","DOI":"10.1016\/j.ophtha.2012.03.045"},{"key":"2025082721594607000_15.12.e253300.25","first-page":"709","article-title":"Current approaches and future directions in the management of pterygium","volume":"11","author":"Kim","year":"2018","journal-title":"Int J Ophthalmol"},{"key":"2025082721594607000_15.12.e253300.26","doi-asserted-by":"publisher","DOI":"10.1016\/S0039-6257(02)00463-0"},{"key":"2025082721594607000_15.12.e253300.27","first-page":"232","article-title":"Scleral necrosis and infection 15 years following pterygium excision","volume":"36","author":"Au Eong","year":"1995","journal-title":"Singapore Med J"},{"key":"2025082721594607000_15.12.e253300.28","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcrs.2008.03.007"},{"key":"2025082721594607000_15.12.e253300.29","first-page":"465","article-title":"Mitomycin C in pterygium treatment","volume":"9","author":"Martins","year":"2016","journal-title":"Int J Ophthalmol"},{"key":"2025082721594607000_15.12.e253300.30","doi-asserted-by":"crossref","first-page":"1050","DOI":"10.1136\/bjo.84.9.1050","article-title":"Necrotising scleritis after bare sclera excision of pterygium","volume":"84","author":"Alsagoff","year":"2000","journal-title":"Br J Ophthalmol"},{"key":"2025082721594607000_15.12.e253300.31","doi-asserted-by":"crossref","first-page":"559","DOI":"10.1097\/ICO.0b013e318165b158","article-title":"Effect of mitomycin C in pterygium surgery on corneal endothelium","volume":"27","author":"Avisar","year":"2008","journal-title":"Cornea"},{"key":"2025082721594607000_15.12.e253300.32","unstructured":"Biswas MC , Shaw C , Mandal R . Treatment of pterygium with conjunctival limbal autograft and mitomycin C--a comparative study. J Indian Med Assoc 2007;105."},{"key":"2025082721594607000_15.12.e253300.33","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajpath.2010.10.037"},{"key":"2025082721594607000_15.12.e253300.34","doi-asserted-by":"publisher","DOI":"10.1136\/bjo.63.2.102"},{"key":"2025082721594607000_15.12.e253300.35","doi-asserted-by":"crossref","first-page":"176","DOI":"10.1016\/S0161-6420(86)33764-3","article-title":"Conjunctival and corneal intraepithelial and invasive neoplasia","volume":"93","author":"Erie","year":"1986","journal-title":"Ophthalmology"},{"key":"2025082721594607000_15.12.e253300.36","first-page":"567","article-title":"Pterygia and carcinoma of the conjunctiva","volume":"88","author":"Sevel","year":"1969","journal-title":"Trans Ophthalmol Soc U K"},{"key":"2025082721594607000_15.12.e253300.37","doi-asserted-by":"publisher","DOI":"10.1001\/archophthalmol.2008.531"},{"key":"2025082721594607000_15.12.e253300.38","doi-asserted-by":"publisher","DOI":"10.1016\/j.canlet.2003.10.026"},{"key":"2025082721594607000_15.12.e253300.39","doi-asserted-by":"crossref","first-page":"172","DOI":"10.1016\/j.exer.2014.10.015","article-title":"Pathophysiology of ocular surface squamous neoplasia","volume":"129","author":"Gichuhi","year":"2014","journal-title":"Exp Eye Res"},{"key":"2025082721594607000_15.12.e253300.40","doi-asserted-by":"publisher","DOI":"10.1111\/j.1442-9071.1985.tb00400.x"},{"key":"2025082721594607000_15.12.e253300.41","doi-asserted-by":"publisher","DOI":"10.1136\/jmg.27.6.392"},{"key":"2025082721594607000_15.12.e253300.42","doi-asserted-by":"crossref","DOI":"10.1136\/bcr-2016-215364","article-title":"Xeroderma pigmentosum with bilateral ocular surface squamous neoplasia and review of the literature","volume":"2016","author":"Kalamkar","year":"2016","journal-title":"BMJ Case Rep"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2022-253300","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T04:59:54Z","timestamp":1756357194000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2022-253300"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,12]]},"references-count":42,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2022,12,15]]},"published-print":{"date-parts":[[2022,12]]}},"alternative-id":["10.1136\/bcr-2022-253300"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2022-253300","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2022,12]]}}}