I had a middle aged egyptian woman  with RA who was already taking all kinds of steroid-sparing immunologics by her rheumatologist ( I forget the names- sorry), who was suffering from chronic injection and discomfort OD, unresponsive to PF. I goofed at first and thought it was episcleritis (there wasn’t much tenderness), and added Acular, but when she returned with no improvement, I remembered to examine the eye in room light, and that’s when I saw the bluish hue of the choroid that screamed scleritis. She could not tolerate Prednisone, so I tried subconj Kenalog, remembering that this is no longer considered contraindicated in scleritis. The eye bled badly when the needle punctured the injected conjunctiva, and the patient at first thought I had made things worse, as it looked awful. But after a week or so, she felt much better, and when the blood cleared, she clearly had resolved. Wouyld anyone had done any differently?