A Young Woman With Unilateral Eye Pain and Erythema

Thalia Salinas; Rod Foroozan, MD


April 10, 2014

Clinical Course

The patient's symptoms, deep scleral and conjunctival injection along 360°, chemosis, and otherwise normal examination are consistent with scleritis. The MRI showing enhancement of the sclera of the right globe helps confirm this diagnosis. The patient was treated with 40 mg of prednisone daily and had a follow-up visit in the next few days.

On her second visit, she reported a marked improvement in her ocular pain and redness, with only slight ocular pain and redness remaining. However, after starting prednisone treatment, she noted insomnia and blood glucose measurements around 240 mg/dL. Given these side effects, she was referred for consideration of periocular steroid injection of the affected eye. She remained on 40 mg of prednisone daily, and was recommended to increase the prednisone dose to 60 or 80 mg daily if her symptoms worsened.

The patient's primary care physician is following her condition and watching for other potential side effects of corticosteroid treatment. Further evaluation and testing to aid in determining whether there is an identifiable cause for the scleritis is pending.


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