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Getting the latest healthcare news for you
Getting the latest healthcare news for you
A 34-year-old woman with a painful red eye and worsening vision was ultimately diagnosed with idiopathic posterior scleritis — a rare, often-missed form of scleral inflammation. The key clue? A characteristic "T-sign" on ultrasound and a serous macular detachment. Prompt corticosteroid treatment restored her vision from near-blindness to 20/40 within days.
A 34-year-old otherwise healthy woman came in with two weeks of deep eye pain, redness, and light sensitivity in her left eye. Initially treated with naproxen for suspected scleritis, she returned urgently when her vision dropped dramatically from 20/20 to counting fingers at 6 feet.
Imaging told the real story. An OCT revealed a neurosensory retinal detachment with significant subretinal fluid, and a B-scan ultrasound showed the hallmark "T-sign" — fluid pooling around the optic nerve sheath — confirming posterior scleritis. An extensive workup ruled out autoimmune, infectious, and malignant causes, placing the diagnosis in the idiopathic category. She was started on oral prednisone, and within 9 days, the subretinal fluid had resolved and her vision recovered to 20/40, with further improvement anticipated.
Key Takeaways:
Why it matters: Posterior scleritis is a sight-threatening condition that's easy to miss, especially when anterior signs resolve while posterior damage quietly progresses. This case is a reminder that a seemingly quiet eye can still harbor serious inflammation — and that timely imaging and treatment can make the difference between lasting vision loss and meaningful recovery.
