This condition is characterized by the destruction of the collagen fibers and the thinning of the sclera. The posterior scleral surface is easily observed with irregularly arranged and dense reflective collagen fibers [22].

This condition is marked by the hyporeflective nodule surrounded by the hyperreflective sclera. AS-OCT clearly illustrates the swollen tissue mixed with the blood vessels and the inflammatory cells (Fig. 4.2) [22].

The B mode ultrasonography is helpful in imaging both anterior and posterior scleritis. However, its main role is in monitoring the posterior scleritis. The retinal, choroidal, and scleral complex is seen as the heterogenous layer surrounded by the echogenic orbital fat and the echolucent vitreous. In posterior scleritis, there is reduction in echogenecity of the posterior coats of the eyeball. The fluid in Tenon’s capsule and the optic nerve sheath gives rise to the “T-sign”. The vertical bar of the ‘T’ being formed by the dilated optic nerve which is echolucent and the horizontal bar formed by the echolucent tenon’s fluid.

CT scanning utilizes the X-rays to generate the cross-sectional scans of the eye and the orbit [23]. It is particularly useful in the presence of granulomatous scleritis where there is destruction of the bone or the sinus infiltration. It is however, unsuitable for monitoring the course of the disease as it employs the X-rays [23].