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Background: Surgically induced necrotizing scleritis (SINS) is a rare sequela that may occur after ocular surgery. We report a case of infectious SINS as a complication of pterygium excision.

Case presentation: A 75-year-old man had undergone pterygium excision in the right eye and developed infectious SINS 10 years post-surgery. The sclera adjacent to the previous site of pterygium excision showed significant thinning with uveal show, complicated with signs of infection including purulent discharge, necrotic sclera, and hypopyon. Conjunctival swab culture yielded Pseudomonas aeruginosa. Blood investigations demonstrated positive rheumatoid factor. The patient was successfully treated with a 2-week course of systemic and topical antibiotics with topical steroid.

Conclusion: SINS may develop post-pterygium excision. Early diagnosis and intervention prevent progression and further complications.