Clinical features and presentation of posterior scleritis: a report of 31 cases.

PURPOSE: To describe clinical features, ocular complications, and visual outcomes of patients with posterior scleritis.

METHODS: Clinical characteristics of a subset of 31 patients with posterior scleritis were studied and compared with 469 patients with anterior scleritis.

RESULTS: Of 500 patients, 31 (6.2%) had posterior scleritis. Most patients presented with subacute (80.6%), unilateral (61.3%) scleral inflammation. Pain was moderate to severe in 54.8% of patients. Concomitant anterior scleritis was observed during follow-up in 77.4% of patients and in all patients with moderate to severe pain. Patients with posterior scleritis were significantly younger (43.6 vs. 54.4 years, p < 0.001) and had significantly higher decrease of vision (29.0 vs. 14.9%, p = 0.027) than those with isolated anterior scleritis.

CONCLUSIONS: Posterior scleritis must be considered in patients with decrease of vision, mild to severe pain, optic disc edema, and/or posterior uveitis. Moderate to severe pain may be associated with poorer visual outcome.