Infectious scleritis mimicking severe ocular inflammation: atypical initial presentation.

Two farmers presented with sudden-onset of severe conjunctival congestion and intense chemosis along with features of anterior uveitis. Intraocular pressure was elevated in the first case. Clinically, a diagnosis of severe ocular inflammation was made. Both were hospitalised and were started on topical and parenteral antibiotics. Subsequently, both presented with scleral abscess and choroidal detachment at the site of abscess. Scleral deroofing was performed which revealed fungal infection in the first and Pseudomonas aeroginosa in the second case. Both patients were treated accordingly and showed dramatic response with development of scarring and thinning along with complete resolution of choroidal detachment. Infective scleritis should be considered as one of the provisional diagnosis in patients presenting with features of unilateral ocular inflammation, especially in cases with history of trauma or in predisposed individuals.