An Atypical Presentation of Posterior Scleritis

Abstract

We report a case of an unusual presentation of posterior scleritis. A 13 year old girl presented with progressive monocular visual loss over one week. She did not complain of pain as a significant symptom. Examination of the fundus revealed a pale raised subretinal lesion temporal to the fovea with overlying exudative retinal detachment. A B-scan ultrasound confirmed choroidal and scleral thickening, retinal detachment and fluid in the sub-Tenon’s space. Fundus fluorescein angiography showed multiple areas of progressively increasing hyperfluorescence (leakage of dye) temporal to the fovea. Systemic evaluation of this patient did not reveal an underlying systemic disorder. The patient was commenced on high dose oral corticosteroids which resulted in resolution of symptoms and clinical features. She made full visual recovery after six weeks of treatment. This case illustrates an interesting presentation of posterior scleritis in a 13 year old and explores clinical features, treatment and prognosis in this age group.