Dr.Isha Agarwal

DR. TANYA JAIN

Abstract

39 years old male presented with diminution of vision in his left eye associated with pain for past 1 month. On examination his BP was raised and his BCVA in the right eye was 6/6 N6, and 1/60 in the affected eye. Fundus examination revealed features of optic neuritis, along with branch retinal artery occlusion. However, there also a large subretinal fluid pocket over posterior pole. OCT revealed large retinochoroidal elevation, with subretinal fluid pockets. B scan revealed a thickened retino-choroidal-scleral complex over posterior pole, and shallow subretinal fluid. A diagnosis of posterior scleritis along with features of optic neuritis and secondary BRAO was made. Trial of oral steroids was given. Patient was symptomatically better, with marked reduction in pain, improvement in visual acuity. Multimodal imaging is the key to diagnosis in such cases with atypical presentations. Also a strong index of clinical suspicion is needed for clinching the diagnosis and the right management