Cluster-like headache caused by posterior scleritis

Abstract

Unilateral periocular pain accompanied by unilateral autonomic symptoms, which are the cardinal signs of cluster headaches or other trigeminal autonomic cephalalgias (TACs), could be present with other diseases involving the retro-orbital or orbital structures (1–4). Among such diseases, posterior scleritis has rarely been described as a cause of unilateral periocular pain and autonomic symptoms. The early presumptive diagnosis of posterior scleritis is important, despite its rare occurrence, due to the possibility of permanent visual loss through its recurrence (5, 6). We describe a patient with posterior scleritis that was attributed to recurrent unilateral cluster-like headaches.