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Posterior scleritis presenting as conjunctivitis in a child

A 14-year-old male child presented with redness and decreased vision in the right eye for 7 days. He was being treated for viral conjunctivitis for right eye at a local hospital. His visual acuity was 6/24 OD and 6/9 OS. Slit-lamp examination revealed diffuse conjunctival congestion in the right eye. Dilated fundus examination revealed mild disc hyperaemia and retinal striae in both the eyes. A peripapillary serous detachment of macula in the right eye was seen on optical coherence tomography. B scan ultrasonography revealed increased scleral thickening and characteristic ‘T’ sign in both the eyes. Investigations revealed no other relevant systemic association. A diagnosis of bilateral posterior scleritis was made. The patient was started on topical steroids and oral non-steroidal anti-inflammatory drugs. Within 2 weeks of therapy the visual acuity improved to 6/6, the serous detachment resolved and retinal striae reduced in both the eyes.