ABSTRACT
The sub-Tenon route for injecting triamcinolone acetonide is one of the
widely practiced surgical techniques for postoperative inflammation
control, but complicated conjunctival and scleral necrosis are rare
occurrences. A 3-year-old boy underwent bilateral cataract surgery and
an anterior sub-tendon injection of triamcinolone (AST) (20mg). One week
later, he presented with conjunctival necrosis at the injection site and
thinning of the sclera in both eyes. Necroses being unresponsive to
conservative management led to surgical debridement and removal of
residual steroid deposits. The conjunctiva healed well without grafting,
and the patient remained stable at the six-month follow-up from the
ocular point of view. This rare but serious complication of periocular
steroid injection in a child demands cautious administration of
steroids, prompt diagnosis of necrosis, and timely intervention to limit
serious ocular morbidity.
Keywords : Sub-Tenon injection, triamcinolone acetonide, scleral
necrosis, pediatric cataract, periocular steroids