THE RHEUMATOID nodule is considered by many to be the most characteristic histologic lesion associated with rheumatoid arthritis. Usually subcutaneous in location and occurring during the course of the disease in 25 to 30 per cent of all patients,¹ nodules have been found in the pleura, pericardium, aortic valve,² mitral valve, sheath of the rectus abdominis, kidney³ and eye. Scleral localization has been designated as scleromalacia perforans,⁴ scleritis necroticans,⁵ necroscleritis nodosa excavans⁶ or nodular episcleritis,⁷ depending on the observer's concept of the lesion. The presence of a scleral lesion in a patient with enlargement of the phalangeal joints was noted by Holthouse in 1893.⁸ In 1938 Verhoeff and King⁶ reviewed 14 previously reported cases and described a carefully observed one of their own. Since then several additional cases have been reported.⁹ The majority of these patients were over the age of 50, and the sex