A37-year-old gentleman presented with complaints ofredness in lefteye of 4 months duration and blurring of vision of 1 month duration. He was referred with a diagnosis ofscleritisand was being treated with topicaland oralsteroids since 3 months but remained symptomatic. He did not haveany systemiccomorbidities. Bestcorrected visualacuitywas 6 / 6. Anterior segmentexamination revealed diffusescleritis with anterior uveitis. Posterior segmentexamination showed exudativeretinal detachment with choroidal detachment, with overlying vitreous hazein the inferotemporal quadrantcorresponding to thearea ofscleritis. Rheumatoid factor was negativeand antinuclearantibody by indirect immunofluorescence was negative. C-reactive proteinwas 6 mg/L,erythrocytesedimentation rate was 10 mm/h. As thescleritis was not responding to steroids he was started on oralmethotrexate 15 mg/week with folicacid. After 2 months ofimmunosuppressivetherapy, there was no improvementand the visionworsened to 3 / 60. Examination revealed aretroiridaltumor in thetemporal halfwith distorted pupil, shallow anteriorchamber,circumcornealcongestion, panuveitis with scleritis,and increased intraocular pressure[Figure 1]. Ultrasound biomicroscopy revealed a homogenous reflective,echoeicciliary bodymass, measuring 4.6 × 3.7 mm,extending from2 to 6 O' clock positionwith overlying episcleralthickening and nasally subluxated lens [Figure 2]. Positron emission tomography revealed no extraocular spread or metastasis.
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