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Ophthalmologic examination revealed elevated intraocular pressure (IOP) and significant conjunctival injection without associated pain or visual disturbance. Blood was observed in Schlemm\u2019s canal (SC), and a thorough investigation for elevated episcleral venous pressure (EVP) was performed. Imaging, including magnetic resonance imaging (MRI) and cerebral angiogram, was unremarkable. A rheumatologic workup led to the diagnosis of granulomatosis with polyangiitis (GPA). The patient\u2019s ocular symptoms improved significantly with systemic steroid treatment. He was subsequently managed with rituximab and avacopan as per standard GPA therapy. This case highlights the importance of considering vasculitis in patients presenting with unexplained elevation of EVP, and painless scleritis, particularly when there are also extraocular complaints.<\/jats:p>","DOI":"10.1155\/crii\/6631904","type":"journal-article","created":{"date-parts":[[2025,11,18]],"date-time":"2025-11-18T08:07:28Z","timestamp":1763453248000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Granulomatosis With Polyangiitis (GPA) Presenting With Painless Scleritis and Ocular Hypertension: Case Report"],"prefix":"10.1155","volume":"2025","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8689-2585","authenticated-orcid":false,"given":"Khaled A.","family":"Elubous","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hady","family":"Saheb","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karin M.","family":"Oliver","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,11,18]]},"reference":[{"key":"e_1_2_11_1_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajoc.2020.100665"},{"key":"e_1_2_11_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajoc.2020.100712"},{"key":"e_1_2_11_3_2","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-030-42634-7_180"},{"key":"e_1_2_11_4_2","doi-asserted-by":"publisher","DOI":"10.22336\/rjo.2023.38"},{"key":"e_1_2_11_5_2","doi-asserted-by":"publisher","DOI":"10.1097\/OPX.0b013e31829689a6"},{"key":"e_1_2_11_6_2","doi-asserted-by":"publisher","DOI":"10.1097\/IOP.0000000000002049"},{"key":"e_1_2_11_7_2","first-page":"2349","article-title":"CT Angiography and MR Angiography in the Evaluation of Carotid Cavernous Sinus Fistula Prior to Embolization: A Comparison of Techniques","volume":"26","author":"Chen C. 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