Acute periscleritis – a variant of idiopathic orbital inflammation

We examined seven patients who had eyelid swelling, proptosis, conjunctival injection, mild orbital pain and visual loss. Although several patients had mild limitation of eye movement, none experienced diplopia. Simultaneous bilateral involvement occurred in two patients. All patients were treated with oral corticosteroids and promptly improved, although recurrences in several required repeat courses of therapy. We identified inflammatory thickening of the posterior ocular wall and Tenon's capsule in some patients by means of B-scan ultrasonography and computerized tomography. We call this variety of anterior orbital inflammation without significant extraocular muscle involvement acute periscleritis, which is distinguished from other forms of idiopathic orbital inflammation and scleritis.