Combined detachments in Wegener's granulomatosis

We report a case with limited Wegener's granulomatosis in which the eye findings were the initial and only evidence of the disease when the patient was first seen. The patient was unusual in that he developed bilateral combined choroidal and retinal detachments and severe necrotising scleritis, which led to bilateral globe perforations and loss of sight. We recommend a trial of cytotoxic agents in progressive ocular inflammatory diseases unresponsive to other medications before there is irreversible loss of vision.