Clinical profile of patients with the first presentation as anterior nodular scleritis — a case series

Abstract

Background: The aims of this study was to report the clinical profile of five patients with features of anterior nodular scleritis as initial presentation in residents of Western Maharashtra. Material and methods: A retrospective review of medical records was done from February 2019 to December 2019. Five new anterior nodular scleritis cases were reported at the tertiary-eye care centre within two months. The slit-lamp examination, anterior-segment photographs, and laboratory data were collected and analysed. Results: A majority of cases (4/5) were presented in females. Three patients had a unilateral presentation, while 2 — had bilateral involvement. The most common presenting symptom was ocular pain and redness. Corneal involvement was seen in 1 case. Two female patients were diagnosed with rheumatoid arthritis, one female had multinodular goitre, and the other two were idiopathic. Three patients responded very well to oral non-steroidal anti-inflammatory drugs NSAIDs), while the rest two were managed with steroids. No patient had to be started on immunosuppressives. All the cases showed complete resolution with the treatment provided. All these patients presented at our centre in the autumn season. All these patients presented at our center in the autumn season only and no new case of anterior scleritis reported before or after this season. Conclusion: Management of scleritis may need a multidisciplinary approach as it may be the only presentation of an underlying systemic disease. It is to be considered in the differentials of red eye that presents with a substantial amount of ocular pain or with the known systemic disorder that leads to scleritis development. Also, there could be a seasonal association of anterior-nodular scleritis like episcleritis.