Solitary choroidal mass: A diagnostic dilemma

Abstract

We report a case of 46-year-old male who had progressive visual loss in right eye for 1 month, preceded by pain. He had visual acuity of hand movement at presentation and examination revealed a choroidal mass lesion in the superior quadrant with exudative retinal detachment. Systemic workup was inconclusive. Fluorescein angiography revealed speckled fluorescence contrary to hypo fluorescence of choroiditis, and the presence of T sign on B-scan led us to the diagnosis of nodular posterior scleritis (NPS). The patient was treated with oral steroids and visual acuity recovered to 6/6. NPS can present as a choroidal mass resembling granuloma; careful workup and investigations can diagnose the entity and result in good treatment outcome.