Which condition typically presents with deep, boring ocular pain and tenderness to palpation?

• A. Scleritis
• B. Episcleritis
• C. Conjunctivitis
• D. Keratitis

Answer: (A)

Pain that is deep and boring with tenderness to palpation points to inflammation of the sclera, i.e., scleritis. The sclera is a deep, thick structure, so inflammation here causes a deep, aching pain that can be severe and worsened by eye movement, with tenderness when the eye is touched or palpated. By contrast, episcleritis usually shows only mild discomfort with superficial redness and little to no tenderness; conjunctivitis presents with itching, discharge, and superficial injection; keratitis causes sharp pain and marked photophobia from corneal involvement rather than deep scleral tenderness. So the described presentation best fits scleritis.