—We thank Dr Singh for his comments. We agree that posterior scleritis is often underdiagnosed and misdiagnosed and that ultrasonography is often the only means of achieving consistently accurate diagnoses. We do not agree, however, with his assertion that posterior scleritis was the cause of choroidal folds in the eight patients in our hypermetropic group.The most common clinical features of posterior scleritis are pain, decreased vision, and ocular inflammation.1 While we acknowledge that some patients may present without some (or any) of these signs and symptoms, they usually have a history of pain and redness that may have been treated with topical corticosteroids.2 None of our eight hypermetropic patients had pain or signs of inflammation nor did they have any relevant history. Furthermore, none of our patients showed the characteristic ultrasonographic findings of scleritis, which include thickening of the choroid and sclera, and edema in
Atta HR, Byrne SF. Choroidal Folds in Posterior Scleritis-Reply. Arch Ophthalmol. 1989;107(2):168–169. doi:10.1001/archopht.1989.01070010174010
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