Abscess and Ulcer Depth

In small circumscribed ulcers, corneal depth can be easily examined with a focal slit-beam. However, when the ulcer is opaque or large and especially when necrotic tissue is present, it can be difficult to judge exact depth of involvement.


This is case of a suture abscess after a 10-0 nylon suture was left after a clear corneal incision after cataract surgery. OCT clearly demonstrates 50% thinning and a full-thickness inflammatory reaction concerning for an impending focal melt and perforation. The angle of the beveled incision is clearly seen.

An older study in the journal Eye (Danjoux JP & Reck AC, 1994) found that ~ 25% patients followed over 3 years had either a loose or broken suture and 45% of these patients were asymptomatic.

Loose or broken sutures must be immediately removed, as flora from the lid and conjunctiva can crawl into the suture tract and form a suture abscess such as the one shown in this case.

Images  courtesy of Brett Levinson, MD of Specialized Eye Care.