SEVERE IDIOPATHIC POSTERIOR SCLERITIS IN CHILDREN

Posterior scleritis is an uncommon condition that usually occurs in ad ults and the diagnosis is often missed. It is even more rare in childr en. We report five cases of the disease in children. The patients pres ented with severe pain in an inflamed eye and usually had orbital sign s with lid swelling and limitation of extraocular movements; four of t he five had optic disc swelling and two had exudative retinal detachme nts. The diagnosis was confirmed on B-scan ultrasonography and CT scan ning and no child had clinical or laboratory evidence of associated sy stemic disease. The disease took a protracted course acid all the chil dren required long-term systemic immunosuppression (15-27 months), whi ch was well tolerated. All children retained good vision and were eith er off treatment or on a small dose of immunosuppression at last follo w-up. This condition, although rare, should be recognised in children as part of the differential diagnosis of acute orbital inflammation.