Successful treatment of Wegener's granulomatosis associated scleritis with rituximab

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Abstract
A 21 year old man with WG, proved on renal biopsy and by anti-neutrophil cytoplasm antibody (ANCA) positivity 6 years earlier, presented with bilateral, painful, red eyes. On examination his visual acuities were 6/4 right eye and 6/5 left eye. Anterior segment examination showed subconjunctival haemorrhage, congested scleral vessels, scleral oedema, peripheral corneal infiltrates, and mild anterior chamber inflammation in each eye. Funduscopy revealed bilateral swollen optic discs with scattered retinal haemorrhages in the right eye. A diagnosis of scleritis was made. Oral prednisolone was increased from 5–40 mg daily and maintenance oral mycophenolate mofetil 2 g daily was continued. Topical prednisolone acetate 1% hourly was commenced to both eyes.