Progressive Scleral Thinning in a Middle-aged Woman
A 50-year-old woman presents with left eye redness and headaches. Her best-corrected visual acuity is 20/20 OD and 20/25 OS. On examination, her left eye has 2 temporal scleral nodules with surrounding hyperemia and no scleromalacia. Laboratory test results show elevated levels of rheumatoid factor and C-reactive protein, and Lyme IgG, IgM, and reflex Western blot assays are positive for antibodies. Further testing shows she is negative for rheumatoid arthritis-associated nodular scleritis; however, new scleral thinning with persistence of the scleral nodules is noted. What would you do next?