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Posterior Scleritis

Presentation

Clinical Presentation The hallmark presenting symptom of posterior scleritis is moderate to severe pain. Patients will often describe a deep, dull, boring pain that, classically, wakes them from sleep. [reviewofophthalmology.com]

Thickening of the posterior walls was present in both eyes, as was fluid under Tenon’s capsule. [ncbi.nlm.nih.gov]

Monocular posterior scleritis presenting as acute conjunctivitis: A case report. Li YZ, Qin XH, Lu JM, Wang YP. Li YZ, et al. World J Clin Cases. 2020 Oct 26;8(20):5030-5035. doi: 10.12998/wjcc.v8.i20.5030. World J Clin Cases. 2020. [pubmed.ncbi.nlm.nih.gov]

Entire Body System

  • Swelling

    Fundus examination may show swelling of the optic nerve, exudative retinal detachment or choroidal effusions. Workup All patients presenting with scleritis should be worked up for associated systemic disease. [reviewofophthalmology.com]

    When the presence of bilateral shallow anterior chambers is accompanied by higher IOP, especially, fundi manifestations can include serous retinal detachment, optic disk swelling, and abnormal findings on fluorescein fundus angiography[7]. [ncbi.nlm.nih.gov]

  • Severe Pain

    Clinical Presentation The hallmark presenting symptom of posterior scleritis is moderate to severe pain. Patients will often describe a deep, dull, boring pain that, classically, wakes them from sleep. [reviewofophthalmology.com]

Neurologic

  • Papilledema

    The primary presenting symptoms are red eye, periocular pain, and headache, and the clinical ocular findings at presentation are wide ranging, including congestion, anterior scleritis, serous retinal detachment, papilledema, and/or higher IOP[5]. [ncbi.nlm.nih.gov]

Workup

Workup All patients presenting with scleritis should be worked up for associated systemic disease. [reviewofophthalmology.com]

Treatment

[…] effects of steroid treatment. [ncbi.nlm.nih.gov]

Treatment The treatment of posterior scleritis can be quite challenging. Topical NSAIDs and topical corticosteroids aren’t typically helpful, so systemic therapy is often initiated. [reviewofophthalmology.com]

Cited by 2 articles Intravitreal dexamethasone implant - a new treatment for idiopathic posterior scleritis: A case report. Zhao YJ, Zou YL, Lu Y, Tu MJ, You ZP. Zhao YJ, et al. [pubmed.ncbi.nlm.nih.gov]

Epidemiology

Posterior Scleritis: Analysis of Epidemiology, Clinical Factors, and Risk of Recurrence in a Cohort of 114 Patients. Ocul Immunol Inflamm 2016;24:1: 6-15. 2. Auer, Herborn, Indocyanine green angiographic features in posterior scleritis. [reviewofophthalmology.com]

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