Nodular Anterior Scleritis

Abstract

Nodular scleritis presents with a nodule (or nodules) that is firm, immobile, and tender to palpation. The nodule varies from yellow to deep red, depending on the local vascular congestion and is usually in the interpalpebral zone, close to the limbus (but can occur anywhere). The underlying sclera may become transparent, but not necrotic. As over 10% of nodular scleritis will progress to necrotizing scleritis. An associated systemic disease may be found in up to 30% of patients, most commonly rheumatoid arthritis but also anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis. Early diagnosis and prompt treatment not only prevent ocular complications, but also may prolong survival by halting the progression of the underlying systemic disease.