Purpose: To report a case of a focal scleral nodule (FSN) that demonstrated growth over three years.
Methods: Case report.
Results: An asymptomatic emmetropic 15-year-old female was referred with an incidental finding of a left fundus lesion on routine examination. On examination, there was an isolated 1.9mm (vertical) X 1.4mm (horizontal) diameter raised, circular, pale, yellow-white lesion with an orange halo located along the inferotemporal vascular arcade. Enhanced depth imaging optical coherence tomography (EDI-OCT) demonstrated a focal protrusion of the sclera with thinning of the overlying choroid, consistent with focal scleral nodule (FSN). On EDI-OCT the horizontal basal diameter measured 3138µm and its height was 528µm. Three years later, the lesion had increased in size to 2.7mm (vertical) X 2.1mm (horizontal) diameter on colour fundus photography and a horizontal basal diameter of 3991µm and height of 647µm on EDI-OCT. The patient remained systemically well without visual complaints.
Conclusion: FSN can increase in size over time, suggesting that scleral remodelling within and around the lesion can occur. Longitudinal observation of FSN can help to inform its clinical course and shed insight into its pathogenesis.