Acute Bilateral Scleritis After Recent Streptococcal Infection

A 67-year-old woman with no prior ocular history and culture-confirmed streptococcal pharyngitis presented with bilateral eye redness, pain with eye movement, swelling, and blurry vision. Her condition worsened with initial conservative treatment. Repeat imaging indicated bilateral scleritis, and laboratory test results showed elevated antistreptolysin-O titers. After steroid treatment, her vision returned to baseline and symptoms resolved. Acute scleritis is important to consider in a patient with recent streptococcal infection despite penicillin treatment. Besides ocular findings, patients may not present with dermatologic or rheumatologic symptoms. Internists should consider repeat imaging and laboratory work-up, as early steroid treatment can rapidly improve the scleritis and recover vision.