Nodular Anterior Scleritis
Features of nodular anterior scleritis include a tender and typically immobile scleral nodule, in addition to the local or diffuse violaceous hue associated with markedly engorged, deep episcleral vessels. Up to 10% of patients with nodular anterior scleritis initially can progress to necrotizing disease, particularly in the setting of an underlying systemic inflammatory condition. It is important to rule out infectious etiologies in cases of nodular anterior scleritis, especially in the presence of necrosis (Fig 7-3). This necrotic change often manifests as an avascular area in the center of the nodule (eventually with superficial ulceration) or as a new independent lesion, extending circumferentially. After resolution of scleral inflammation, increased scleral translucency may be seen, eventually with thinning (Fig 7-4) and even formation of a staphyloma.
Excerpted from BCSC 2020-2021 series: Section 9 - Uveitis and Ocular Inflammation. For more information and to purchase the entire series, please visit https://www.aao.org/bcsc.