Case Study 48 Orbital Myositis and Scleritis

Abstract

MK is a 32-year-old woman who complained of redness and discomfort of her right eye for several days. Her pain was worse when she looked to the left. Clinical examination demonstrated focal injection over the area of the medial rectus tendon. A- and B-scan showed thickening and low reflectivity of this tendon. The medial rectus muscle belly appeared to be of normal thickness and internal reflectivity. The adjacent sclera was slightly thickened with increased echolucency of subtenon’s space (Fig. 1). She responded to an oral anti-inflammatory with resolution of her symptoms over several weeks.

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MK is a 32-year-old woman who complained of redness and discomfort of her right eye for several days. Her pain was worse when she looked to the left. Clinical examination demonstrated focal injection over the area of the medial rectus tendon. A- and B-scan showed thickening and low reflectivity of this tendon. The medial rectus muscle belly appeared to be of normal thickness and internal reflectivity. The adjacent sclera was slightly thickened with increased echolucency of subtenon’s space (Fig. 1). She responded to an oral anti-inflammatory with resolution of her symptoms over several weeks.

Fig. 1

B-scan of focal scleritis (first arrow) adjacent to an inflamed extraocular muscle (second arrow)

Scleritis may present as a deep boring pain in the eye. The B-scan is often useful in the demonstration of focal scleral thickening with typical inflammatory edema of the adjacent subtenon’s space, which appears as echolucency on the scan. The A-scan correlates with high-to-medium reflective thickening of the sclera and low reflectivity in the retrobulbar space.