Chronic ophthalmic Wegener's granulomatosis

A case of Wegener's granulomatosis is reported which manifested episcleritis followed by scleritis, and followed in turn by separate episodes of right and left orbital pseudotumor spanning 15 years prior to respiratory tract disease. The unusually protracted progression of symptoms in this case may be explained on the basis of the histopathological findings. Areas of fibrinoid necrosis of connective tissue occurred alone or alternated with areas of nongranulomatous fibrinoid necrosis of blood vessel walls. Granulomatours vasculitis was not observed. This histopathological picture is pathognomic of early cases of Wegener's granulomatosis which run especially protracted courses.