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Arch Ophthalmol. 2000;118:1290-1292.

A 41-year-old asymptomatic woman was referred for enucleation of a 7.5-mm-thick intraocular tumor suspected to be choroidal melanoma. The clinical findings combined with imaging studies suggested instead a diagnosis of giant nodular posterior scleritis. A scleral biopsy was performed to confirm the diagnosis. After 12 years of observation, the lesion has remained stable and visual acuity has been preserved. Nodular posterior scleritis can present with no symptoms of pain, redness, or visual disturbance and can remain quiet for many years. It must be clinically differentiated from choroidal melanoma.

Hakan Demirci, MD; Carol L. Shields, MD; Santosh G. Honavar, MD; Jerry A. Shields, MD; David S. Bardenstein, MD
From the Oncology Service, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, Pa (Drs Demirci, C. Shields, Honavar, and J. Shields); and the Department of Ophthalmology, Case Western University, Cleveland, Ohio (Dr Bardenstein).