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October 1993

Scleritis in Association With Poststreptococcal Vasculitis

Author Affiliations

London, England

Arch Ophthalmol. 1993;111(10):1324-1325. doi:10.1001/archopht.1993.01090100030017

Scleritis is a focal or diffuse inflammatory disorder of sclera and deep episclera and is commonly associated with the vasculitis of certain specific systemic diseases, such as rheumatoid arthritis and Wegener's granulomatosis. Scleritis has been thought to be a manifestation of immune complex-mediated vasculitis,1 but T-cell mechanisms are likely to play an important role in at least some patients.2,3 We describe herein a patient who developed severe scleritis and systemic vasculitis following a streptococcal pharyngitis.

Report of a Case.  A 41-year-old woman presented to the accident and emergency department with a 3-day history of very painful red eyes with increasingly severe brow ache and headache. Seven days before the onset of the ocular symptoms, she had a culture-proven streptococcal pharyngitis that her local general practitioner had treated successfully with 500 mg of oral penicillin four times a day. On examination, she had bilateral, intense, diffuse scleral hyperemia and