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Severe idiopathic posterior scleritis in children
W H Woon1, M R Stanford, E M Graham
1Medical Eye Unit, St Thomas' Hospital, London, UK.
Eye (London, England)
|January 1, 1995
Summary
Posterior scleritis, a rare eye inflammation in children, presents with severe pain and orbital signs. Prompt diagnosis and long-term immunosuppression are key for good vision outcomes.
Area of Science:
- Ophthalmology
- Pediatric Ophthalmology
Background:
- Posterior scleritis is an uncommon inflammatory eye condition, rarely diagnosed in children.
- Early diagnosis is often missed due to its rarity and varied presentation in pediatric patients.
Observation:
- Five pediatric cases of posterior scleritis presented with severe eye pain, inflammation, and orbital signs like lid swelling and restricted eye movements.
- Optic disc swelling was observed in four patients, and exudative retinal detachments in two, confirmed via B-scan ultrasonography and CT scans.
- No associated systemic diseases were identified in the affected children.
Findings:
- Posterior scleritis in children follows a protracted course requiring prolonged systemic immunosuppression (15-27 months).
- Treatment with immunosuppression was well-tolerated by all patients.
- All children maintained good vision, with most either off treatment or on low-dose maintenance at follow-up.
Implications:
- Posterior scleritis should be considered in the differential diagnosis of acute orbital inflammation in children.
- Recognizing this rare condition is crucial for timely intervention and preserving visual acuity in pediatric patients.
- Long-term immunosuppression appears effective and safe for managing pediatric posterior scleritis.