Idiopathic posterior scleritis: A masquerade of acute angle-closure attack

Abstract

We report a case of a 51-year-old gentleman who presented with diffuse conjunctival congestion, chemosis, and shallow anterior chamber only in his left eye (LE), with an intraocular pressure of 26 mmHg, and closed angles on gonioscopy. B-scan ultrasonography of the LE showed increased choroidal thickness with minimum suprachoroidal fluid effusion. A diagnosis of anterior and posterior scleritis with secondary angle closure was made. The patient showed a favorable response to oral and topical steroids with cycloplegics. Idiopathic scleritis can mimic an acute attack of angle closure. Prompt recognition of the same is vital to providing good clinical outcomes.

Keywords

• posterior scleritis
• unilateral acute angle-closure attack
• laser peripheral iridotomy
• oral steroids