Posterior scleritis presenting with angle closure glaucoma.

PURPOSE: To report a case of posterior scleritis associated with angle closure glaucoma and transient myopia.

METHODS

A previously healthy 29-year-old male was referred for YAG laser iridotomy to treat angle closure glaucoma. He was suffering from severe pain and vision loss in his right eye. Findings on examination were hyperemia, proptosis, and myopia measuring approximately 6 diopters. Diagnosis of posterior scleritis was made due to presence of choroidal thickening, sub-Tenon effusion and the classical "T" sign observed on orbital ultrasonography.

RESULTS

Treatment was initiated using oral prednisolone. After 8 days, the patient's symptoms regressed and visual acuity returned to 20/20.

CONCLUSIONS

Posterior scleritis is an often misdiagnosed eye disease. Pain is the main symptom and may be accompanied by decrease in visual acuity. Early diagnosis and treatment is important to avoid permanent visual loss.