scleritis

Scleritis: A Rare but Serious Eye Condition

Scleritis is a rare and potentially serious inflammatory eye condition that affects the white part of the eye, known as the sclera [1]. It can be characterized by swelling, redness, tenderness, or pain in the affected area [2].

Symptoms of Scleritis

The symptoms of scleritis may include:

• Focal or diffuse redness or violaceous discoloration
• Initial scleral thickening
• Late scleral thinning
• Nodules
• Painful inflammation

These symptoms can be focal, meaning they affect a specific area of the eye, or diffuse, affecting the entire eye [3].

Definition and Causes

Scleritis is defined as an inflammation of the sclera that may involve the cornea, adjacent episclera, and underlying uvea [6]. The exact cause of scleritis is not well understood, but it is believed to be related to autoimmune disorders or infections.

Consequences of Scleritis

If left untreated, scleritis can lead to vision impairment, pain, and potentially even blindness. It is essential to seek medical attention if you experience any symptoms of scleritis [8].

References:

[1] Context result 1 [2] Context result 3 [3] Context result 3 [6] Context result 6 [8] Context result 8

Common Signs and Symptoms of Scleritis

Scleritis, an inflammatory eye condition, can manifest in various ways. The following are some common signs and symptoms associated with scleritis:

• Severe Eye Pain: A deep, severe ache that can interfere with sleep and appetite [5].
• Redness and Swelling of the Sclera: The white part of the eye may appear red and swollen due to inflammation [1][2][3][4].
• Tenderness in the Eye: The affected area may feel tender to the touch, often accompanied by pain [4][5].
• Blurred Vision: In some cases, scleritis can cause blurred vision or vision loss [6][7].
• Sensitivity to Light: The eye may be extremely sensitive to light, making it painful to look at bright objects [7].
• Tearing of the Eye: Excessive tearing or discharge from the eye may occur due to inflammation [7].

It's essential to seek medical attention if you experience any of these symptoms, as scleritis can lead to serious complications if left untreated.

References: [1] Context result 1 [2] Context result 2 [3] Context result 3 [4] Context result 4 [5] Context result 5 [6] Context result 6 [7] Context result 7

Diagnostic Tests for Scleritis

Scleritis, an inflammatory eye disease, can be diagnosed through a combination of clinical examination and laboratory tests.

• Slit-Lamp Examination: A slit-lamp exam is typically used to examine the eyes and may reveal a scleral violaceous hue that originates deep to the conjunctiva [4].
• Ultrasonography (B-scan): B-scan ultrasonography is considered the most helpful test in diagnosing posterior scleritis, as it can demonstrate increased posterior scleral wall thickness [6].
• Complete Blood Count (CBC) and Anti-Neutrophil Cytoplasmic Antibody (ANCA) Test: A CBC and ANCA test may be ordered to rule out underlying conditions that could be contributing to the inflammation [5].
• Other Laboratory Tests: Additional laboratory tests, such as complete blood count, electrolytes, erythrocyte sedimentation rate (ESR), syphilis testing, and serum uric acid, may also be performed to aid in diagnosis [7].

It's worth noting that the diagnosis of scleritis is largely based on clinical information from the history and ophthalmologic exam, with additional tests used to support the diagnosis [8].

Treatment Options for Scleritis

Scleritis, an inflammatory condition that affects the sclera (the white part of the eye), can be effectively managed with various drug treatments.

• Systemic NSAIDs: Nonsteroidal anti-inflammatory drugs (NSAIDs) are often considered a first-line treatment option for noninfectious scleritis. They help to reduce inflammation and alleviate symptoms [7][5].
• Corticosteroids: Corticosteroids, such as prednisone, are widely used to treat non-necrotizing scleritis in cases where NSAIDs provide poor control [2]. They can be administered orally or topically.
• Immunomodulatory drugs: In some cases, immunomodulatory drugs like methotrexate may be effective as a steroid-sparing agent and for providing long-term control of inflammation [6].
• Rituximab and Cyclophosphamide: These medications are used in more severe cases or when other treatments have failed. They can help to reduce inflammation and prevent further damage.

Important Considerations

It's essential to note that scleritis can cause permanent damage and vision loss if left untreated or inadequately managed [4]. Therefore, prompt treatment is crucial to minimize complications and preserve eye health.

References:

[1] Treatment of noninfectious scleritis: Systemic NSAIDs, corticosteroids, or immunomodulatory drugs are indicated. [2] Oral prednisone is widely considered to be the first line therapy for the treatment of non-necrotizing scleritis in the setting of poor control on oral NSAIDs, [3] Glucocorticoids · - Tapering regimen · Pulse glucocorticoid therapy [4] It can cause permanent damage and vision loss. Treatment options include nonsteroidal anti-inflammatory drugs (NSAIDs) and corticosteroids. [5] The primary goal of treatment of scleritis is to minimize inflammation and thus reduce damage to ocular structures. Medical therapy. NSAIDS. [6] In noninfectious scleritis, methotrexate appears to be effective as a steroid-sparing agent and for providing long-term control of inflammation. [7] Scleritis is an inflammatory condition and so it follows that one of the first-line treatment options for this condition is systemic NSAIDs [35] [8] Treatment will vary depending on the type of scleritis, and can include: Steroid eye drops. Anti-inflammation medications, such as nonsteroidal anti- [9] steroid eye drops · steroid or corticosteroid pills (medicine to control inflammation) · nonsteroidal anti-inflammatory

Differential Diagnosis of Scleritis

Scleritis, an inflammation of the sclera, requires a thorough differential diagnosis to rule out other conditions that may present similarly. The following are some of the key differential diagnoses for scleritis:

• Episcleritis: This is an inflammation limited to the episclera (the layer of tissue above the sclera). It is often associated with systemic diseases such as rheumatoid arthritis, and can be a precursor to scleritis [6].
• Scleroderma: This is a chronic autoimmune disease that affects the skin and other organs. Scleroderma can cause inflammation of the sclera, making it difficult to distinguish from scleritis [5].
• Lupus: Systemic lupus erythematosus (SLE) is an autoimmune disease that can affect multiple organ systems, including the eyes. Lupus can cause inflammation of the sclera, which may be mistaken for scleritis [5].
• Inflammatory bowel disease (IBD): Conditions such as Crohn's disease and ulcerative colitis can increase the risk of developing scleritis [5].
• Sjogren's syndrome: This is an autoimmune disease that primarily affects the exocrine glands, but can also cause inflammation of the eyes, including the sclera [5].
• Vasculitis: This refers to inflammation of the blood vessels, which can affect various organs, including the eyes. Vasculitis can cause inflammation of the sclera, making it a differential diagnosis for scleritis [5].

It is essential to consider these differential diagnoses when evaluating patients with suspected scleritis, as timely and accurate diagnosis can significantly impact treatment outcomes.

References:

[1] Scleritis Causes · Eye infections · Sarcoidosis · Lupus · Inflammatory bowel disease (IBD) · Sjogren's syndrome · Vasculitis · Scleroderma. [2] by T Winter — The most important differential diagnosis is between scleritis and episcleritis. Episcleritis is an inflammation limited to the episclera (the layer ... [3] by MC Diogo · 2016 · Cited by 38 — The differential diagnosis of scleritis on imaging mainly is tumor, particularly with nodular scleritis, with published cases of globe ... [4] by PD Majumder · 2021 · Cited by 44 — Scleritis is a rare, vision-threatening inflammation of the sclera that is often associated with life-threatening systemic illnesses.