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Introduction Early diagnosis and initiation of immunosuppression can prevent the necessity of surgical intervention in necrotizing scleritis with inflammation and lowers the risk of perforation and loss of vision. However, clinical signs for early diagnosis and methods for monitoring response to immunosuppressive therapy are missing. Methods Here, we present a case of necrotizing scleritis with inflammation where avascular plaques precede scleral defects. We use slit lamp imaging and anterior segment optical coherence tomography to evaluate evolution lesions depth and impact on scleral structure. Results The patient presented 5 months after detection of avascular plaques with a new scleral ulcer of the left eye. After 3-day-administration of i.v. corticosteroids anterior segment optical coherence tomography showed progressive scleral thickening. The patient was therefore spared surgical intervention and discharged resulting in complete remission under decreasing doses of oral corticosteroids. Conclusions Avascular plaques can precede necrotizing scleritis with inflammation by several months and may therefore qualify as early clinical signs. Anterior segment optical coherence tomography enables objective evaluation of scleral structure for making rational decisions about surgical intervention.

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Purpose: To analyse ocular biometric parameters in men and women in a population of cataract surgery candidates and determine whether statistically significant differences exist. Methods: A cross‐sectional study of 5034 eyes of 2671 patients was performed. Biometric parameters of the eyes were measured by Zeiss IOLMaster 700. The axial length (AL), mean anterior radio (aR), mean posterior radio (pR), central corneal thickness (CCT), anterior chamber depth (ACD) (epithelium to lens), lens thickness (LT), and White to White corneal diameter (W2W) were evaluated. These data represent normative biometric values for the Valencian population. Results: The mean age in the male group was 73 ± 9.6 years, the mean age in the female group was 73.8 ± 8.3 years. The male/female ratio was 0.84. The male–female difference, with a 95% confidence interval (CI) in AL, ACD, and LT were 0.65 mm [0.57; 0.73] (p < 0.01), 0.17 mm [0.14; 0.2] (p < 0.01), and 0.031 mm [0.005; 0.5] (p < 0.05), respectively. Differences (95% CI) in W2W and CCT were 0.18 mm [0.15; 0.20] (p < 0.01), and 4.89 μm [2.55; 7.23] (p < 0.01). Differences (95% CI) in aR and pR were 0.137 mm [0.12; 0.153] (p < 0.01) and 0.122 mm [0.106; 0.139] (p < 0.01). All biometric eye parameters (AL, aR, pR, CCT, ACD, LT, W2W) measured, were lower in females than in males, with a statistically significant difference. Conclusions: Statistically significant differences between genders were found in all the biometric parameters evaluated. In our population, women's eyes are smaller than men's in all biometric parameters that shape them. Gender must be taken into account in the biometric evaluation of the eye. These results may be relevant in intraocular lens power calculation and in the evaluation of refractive error.