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Painless Posterior Scleritis: A Rare Presentation.

Summaya Khan¹, Mahum Faheem¹, Imran Basit¹

¹Department of Ophthalmology, Armed Forces Institute of Ophthalmology, Rawalpindi, Pakistan.

Journal of the College of Physicians and Surgeons--Pakistan : JCPSP

|May 24, 2021

Summary

This summary is machine-generated.

Posterior scleritis, a rare condition, can mimic other eye diseases. This case highlights its varied presentation, including exudative retinal detachment and disc edema, diagnosed via imaging and treated successfully with steroids.

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Area of Science:

Ophthalmology
Inflammatory eye diseases

Background:

Posterior scleritis is an uncommon and often misdiagnosed condition.
Its varied clinical presentation can lead to diagnostic challenges.

Observation:

A 48-year-old female presented with progressive vision loss in her left eye.
Clinical examination revealed multiple exudative retinal detachments, choroidal folds, and disc edema.
The patient reported no ocular pain, an atypical presentation for posterior scleritis.

Findings:

B-scan ultrasonography and contrast-enhanced MRI of the orbit demonstrated the characteristic 'T-sign'.
The 'T-sign' on orbital imaging is indicative of scleral and choroidal thickening, a hallmark of posterior scleritis.
The patient showed significant clinical improvement following treatment with oral steroids.

Implications:

This case underscores the need for a high index of suspicion for posterior scleritis, even in the absence of pain.
Advanced imaging techniques like MRI are invaluable for diagnosing posterior scleritis when clinical presentation is atypical.
Prompt diagnosis and treatment of posterior scleritis can lead to favorable visual outcomes.