Nodular posterior scleritis with associated choroiditis masquerading as a choroidal tumour- A Case Report

Authors

  • Muhammad Amer Awan Department of Ophthalmology, Shifa International Hospital, Islamabad, Pakistan
  • Fatima Mohsin Department of Ophthalmology, Shifa International Hospital, Islamabad, Pakistan
  • Abdullah Ahmed Fourth Year MBBS Student, Allama Iqbal Medical College, Lahore, Pakistan
  • Muhammad Suhail Sarwar Department of Ophthalmology, Suhail Oculab Hospital, Lahore, Pakistan
  • Tahir Hashmi Department of Rheumatology, Shifa International Hospital, Islamabad, Pakistan

DOI:

https://doi.org/10.47391/JPMA.7895

Keywords:

Posterior scleritis, Choroiditis, Choroidal mass, Methotrexate

Abstract

We report a case of nodular posterior scleritis in a 25-year-old male who presented with a 14-day history of unilateral decline in vision, pain, and redness in his right eye. Slit lamp examination of the right eye revealed dilated episcleral vessels present nasally as well as a choroidal mass at the nasal periphery of the fundus, associated with choroidal oedema. Systemic evaluation and imaging of the choroidal mass were performed to rule out choroidal tuberculoma and choroidal metastasis. Ultrasound B-scan of the right eye showed marked thickening of the nasal sclera resulting in sympathetic choroidal oedema without the characteristic T-sign. Nodular posterior scleritis with associated choroiditis, was diagnosed without any underlying systemic illness. The patient was immediately started on systemic steroids and later on subcutaneous Methotrexate as advised by the rheumatologist, to which he responded well and his vision significantly improved from 6/60 to 6/9, gradually during his treatment course.

Author Biographies

Muhammad Amer Awan, Department of Ophthalmology, Shifa International Hospital, Islamabad, Pakistan

Consultant Ophthalmologist

Fatima Mohsin, Department of Ophthalmology, Shifa International Hospital, Islamabad, Pakistan

2nd year Resident Ophthalmology

Abdullah Ahmed, Fourth Year MBBS Student, Allama Iqbal Medical College, Lahore, Pakistan

Fourth year medical student

Tahir Hashmi, Department of Rheumatology, Shifa International Hospital, Islamabad, Pakistan

Consultant Ophthalmologist

Published

2023-08-15

How to Cite

Muhammad Amer Awan, Mohsin, F., Abdullah Ahmed, Muhammad Suhail Sarwar, & Tahir Hashmi. (2023). Nodular posterior scleritis with associated choroiditis masquerading as a choroidal tumour- A Case Report. Journal of the Pakistan Medical Association, 73(9), 1903–1905. https://doi.org/10.47391/JPMA.7895

Issue

Section

CASE REPORT