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Posterior scleritis is a rare sight-threatening condition that typically presents with an acutely painful eye, often with associated reduced visual acuity. Diagnosis can be challenging and requires specialist ophthalmological assessment. Consequences of delayed treatment include permanent loss of vision. We present a case of posterior scleritis initially managed as periorbital cellulitis. We highlight the importance of broad differential diagnoses when assessing painful periorbital swelling, and present a review of current management strategies for posterior scleritis.

More Than Meets the Eye: A Rare Case of Posterior Scleritis Masquerading as Orbital Cellulitis