Case Study 27 Posterior Scleritis

Abstract

MH is a 21-year-old man who complained of pain behind his left eye and reduction in vision. Examination found a slightly elevated lesion temporal to the macula. A malignant tumor was included among the diagnostic possibilities. B-scan revealed choroidal and lateral rectus tendon thickening (Fig. 1). This picture was felt most consistent with posterior scleritis with involvement of the lateral rectus tendon, and the patient responded rapidly to a tapering dose of prednisone.

MH is a 21-year-old man who complained of pain behind his left eye and reduction in vision. Examination found a slightly elevated lesion temporal to the macula. A malignant tumor was included among the diagnostic possibilities. B-scan revealed choroidal and lateral rectus tendon thickening (Fig. 1). This picture was felt most consistent with posterior scleritis with involvement of the lateral rectus tendon, and the patient responded rapidly to a tapering dose of prednisone.

Fig. 1

B-scan of subtenon’s lucency (first arrow) with adjacent lateral rectus tendon thickening (second arrow)

Suspicious conjunctival lesions can sometimes be associated with intraocular or orbital processes.