Rheumatoid scleritis.

A 59-year-old black female with rheumatoid arthritis developed diffuse anterior scleritis with orbital and adnexal involvement. Computerized axial tomograhy (CAT) demonstrated the location and extent of the lesion. Biopsy of subconjunctival tissue revealed a rheumatoid nodule, characterized by granulomatous inflammation and fibrinoid necrosis. The patient improved rapidly on large doses of systemic corticosteroids. The relationship of scleritis to rheumatoid arthritis is discussed. The histopathologic features of rheumatoid scleritis, its apppearance on the CAT scan, and the management of this disease are also presented.