Dr. Anushri Agrawal, Dr. Kirandeep Kaur, Dr. S Bala Murugan, Dr. Annamalai O
Purpose: To describe the evolution of scleritis from anterior to posterior in the same patient.
Method: A 71/F patient presented with complaints of pain and redness in LE since 1 month. Her BCVA was 6/18 in BE and IOP was normal. Examination revealed acute non granulomatous anterior uveitis with anterior scleritis. Fundoscopy showed ERM and macular pucker. ESR was raised and baseline blood parameters were normal. We initiated oral steroids, cycloplegic and lubricants.
Result: At 1 week LE vision reduced to HM+. Fundoscopy showed bullous RD and shallow CDs. B scan showed vitritis, RCS thickening with T-sign and suprachoroidal fluid indicating posterior extension of scleritis. With parenteral steroids BCVA improved to 2/60. Finally with tapering oral steroids and Methotrexate BCVA improved to 6/24 with clinical resolution.
Conclusion: Aggressive treatment with steroids and immunosuppressives are the key to success in noninfectious scleritis extending both anteriorly and posteriorly.
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