Presumed Posterior Scleritis Complicated by Serous Retinal Detachment as a Possible Late Manifestation of COVID-19 Infection: A Pediatric Case Report.

A wide range of systemic and ocular symptoms have been associated with 2019 novel coronavirus (COVID-19) infection, including long-term alterations in inflammatory pathways. We describe a novel case of an 11-year-old female presenting with posterior scleritis and associated serous retinal detachment, occurring one year after confirmed COVID-19 infection. The patient presented with a one-day history of central scotoma following three days of progressive right eye pain, photophobia, conjunctival injection, and blurred vision. She reported two prior episodes of right eye pain, the first of which occurred in the setting of acute COVID-19 infection. Examination revealed clinical signs of posterior scleritis with serous retinal detachment. Laboratory work-up for infectious and autoimmune etiologies was unremarkable. The patient was treated with topical corticosteroids and nonsteroidal anti-inflammatory therapy, resulting in complete resolution of symptoms and restoration of visual acuity. Despite the atypical response, posterior scleritis remains the presumed diagnosis based on recurrent episodes and clinical findings. The temporal association with initial COVID-19 infection raises the possibility of an etiological role, though it remains unclear whether persistent viral antigens or a dysregulated immune response underlie the condition. This case introduces posterior scleritis as a potential delayed ocular manifestation of COVID-19 infection and highlights the need for further research into post-viral inflammatory responses affecting the eye. For clinicians, it emphasizes the importance of considering recent or remote COVID-19 infection in the differential diagnosis of posterior segment inflammation.