Staphyloma

Staphyloma refers to a localised bulging of weak and
thin outer tunic of the eyeball (cornea or sclera), lined
by uveal tissue which shines through the thinned
out fibrous coat.
Types
Anatomically it can be divided into anterior,
intercalary, ciliary, equatorial and posterior
staphyloma

1. Anterior staphyloma. An ectasia of psuedocornea
(the scar formed from organised exudates and
fibrous tissue covered with epithelium) which
results after total sloughing of cornea, with iris
plastered behind it is called anterior staphyloma

2. Intercalary staphyloma. It is the name given to
the localised bulge in limbal area lined by root of iris
(Figs. 6.8A and 6.9). It results due to ectasia of weak
scar tissue formed at the limbus, following healing of
a perforating injury or a peripheral corneal ulcer. There
may be associated secondary angle closure glaucoma,

which may cause progression of bulge if not treated.
Defective vision occurs due to marked corneal
astigmatism.

Treatment consists of localised staphylectomy under
heavy doses of oral steroids.
3. Ciliary staphyloma. As the name implies, it is the
bulge of weak sclera lined by ciliary body. It occurs
about 2-3 mm away from the limbus (Figs. 6.8B and
6.10). Its common causes are thinning of sclera
following perforating injury, scleritis and absolute
glaucoma.
4. Equatorial staphyloma. It results due to bulge of
sclera lined by the choroid in the equatorial region
(Fig. 6.8C). Its causes are scleritis and degeneration
of sclera in pathological myopia. It occurs more
commonly at the regions of sclera which are
perforated by vortex veins.
5. Posterior staphyloma. It refers to bulge of weak
sclera lined by the choroid behind the equator (Fig.
6.8D). Here again the common causes are pathological
myopia, posterior scleritis and perforating injuries. It
is diagnosed on ophthalmoscopy. The area is

excavated with retinal vessels dipping in it (just like
marked cupping of optic disc in glaucoma) (Fig. 6.11).
Its floor is focussed with minus number lenses in
ophthalmo-scope as compared to its margin.