Scleromalacia perforans is a painless anterior necrotizing scleritis without inflammatory signs. The stereopicture shows a well-circumscribed conjunctival ulceration and severe thinning of the sclera which allows direct visualization of the choroid. This condition - associated with longstanding seropositive rheumatoid arthritis - rarely causes spontaneous perforation but traumatic perforation may easily occur. Treatment consists in preventing the progression of this disease by the use of systemic corticosteroids, non-steroidal anti-inflammatory drugs as well as methotrexate, azathioprine, cyclophosphamide, etc. |