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Scleritis

Inflammation - sclera

 

The sclera is the white outer wall of the eye. Scleritis is present when this area becomes swollen or inflamed.

Causes

 

Scleritis is often linked to autoimmune diseases. These diseases occur when the body's immune system attacks and destroys healthy body tissue by mistake. Diseases such as rheumatoid arthritis and systemic lupus erythematosus can cause this problem. Sometimes the cause is unknown.

Scleritis occurs most often in people between the ages of 30 and 60. It is rare in children.

 

Symptoms

 

Symptoms of scleritis include:

  • Blurred vision
  • Eye pain and tenderness -- severe
  • Red patches on the normally white part of the eye
  • Sensitivity to light -- very painful
  • Tearing of the eye

A rare form of this disease causes no eye pain or redness.

 

Exams and Tests

 

Your health care provider will perform the following tests:

  • Eye exam
  • Physical exam and blood tests to look for conditions that may be causing the problem

It is important for your provider to determine if you have scleritis. The symptoms can also be a less severe form of inflammation, such as episcleritis.

 

Treatment

 

Treatments for scleritis may include:

  • Corticosteroid eye drops to help reduce the inflammation
  • Corticosteroid pills
  • Newer, nonsteroid anti-inflammatory drugs (NSAIDs) in some cases
  • Certain anticancer drugs (immune-suppressants) for severe cases

If scleritis is caused by an underlying disease, treatment of that disease may be needed.

 

Outlook (Prognosis)

 

In most cases, the condition goes away with treatment. But it may come back.

The disorder causing scleritis may be serious. However, it may not be discovered the first time you have the problem. The outcome will depend on the specific disorder.

 

Possible Complications

 

Complications may include:

  • Return of scleritis
  • Side effects of long-term corticosteroid therapy
  • Perforation of the eyeball, leading to vision loss if the condition is left untreated

 

When to Contact a Medical Professional

 

Call your provider or ophthalmologist if you have symptoms of scleritis.

 

Prevention

 

Most cases cannot be prevented.

People with autoimmune diseases, may need to have regular check-ups with an ophthalmologist familiar with the condition.

 

 

References

Boyd K. Scleritis. American Academy of Ophthalmology Web site. www.aao.org/eye-health/diseases/what-is-scleritis. Accessed September 1, 2016.

Watson P. Diseases of the sclera and episclera. In: Tasman W, Jaeger EA, eds. Duane's Ophthalmology, 2013 Edition. Philadelphia, PA: Lippincott Williams & Wilkins; 2013:vol 4, chap 23.

Yanoff M, Cameron JD. Diseases of the visual system. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 423.

 
  • Eye

    Eye - illustration

    The eye is the organ of sight, a nearly spherical hollow globe filled with fluids (humors). The outer layer or tunic (sclera, or white, and cornea) is fibrous and protective. The middle tunic layer (choroid, ciliary body and the iris) is vascular. The innermost layer (the retina) is nervous or sensory. The fluids in the eye are divided by the lens into the vitreous humor (behind the lens) and the aqueous humor (in front of the lens). The lens itself is flexible and suspended by ligaments which allow it to change shape to focus light on the retina, which is composed of sensory neurons.

    Eye

    illustration

    • Eye

      Eye - illustration

      The eye is the organ of sight, a nearly spherical hollow globe filled with fluids (humors). The outer layer or tunic (sclera, or white, and cornea) is fibrous and protective. The middle tunic layer (choroid, ciliary body and the iris) is vascular. The innermost layer (the retina) is nervous or sensory. The fluids in the eye are divided by the lens into the vitreous humor (behind the lens) and the aqueous humor (in front of the lens). The lens itself is flexible and suspended by ligaments which allow it to change shape to focus light on the retina, which is composed of sensory neurons.

      Eye

      illustration


     

    Review Date: 8/20/2016

    Reviewed By: Franklin W. Lusby, MD, ophthalmologist, Lusby Vision Institute, La Jolla, CA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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