scleritis

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Scleritis is a serious inflammatory disease that affects the white outer coating of the eye, known as the sclera. The disease is often contracted through association with other diseases of the body, such as Wegener's granulomatosis or rheumatoid arthritis; it can also be attained through disorders of menstruation. For this reason, scleritis occurs frequently among young women. There are three types of scleritis: diffuse scleritis (the most common), nodular scleritis, and necrotizing scleritis (the most severe). Scleritis may be the first symptom of onset connective tissue disease[1].

The term "Episcleritis" refers to inflammation of the episclera.

Signs and symptoms

Symptoms of the disease include:

• Redness of the sclera and conjunctiva, sometimes changing to a purple hue
• Severe ocular pain (not present in episcleritis) which may radiate to the temple or jaw
• Photophobia and tearing
• Decrease in visual acuity, possibly leading to blindness
• a slight loss of vision of the eye

Diagnosis

Scleritis is best detected by examining the sclera in daylight; retracting the lids helps determine the extent of involvement. Other aspects of the eye exam (i.e. visual acuity testing, slit lamp examination, etc) can be normal. Ancillary tests CT scans, MRIs, and ultrasonographies can be helpful, but do not replace the physical examination.

Treatment

In very severe cases of necrotizing scleritis, eye surgery must be performed to repair damaged corneal tissue in the eye and preserve the patient's vision. For less severe cases, nonsteroidal anti-inflammatory drugs, such as ibuprofen, are prescribed for pain relief. Scleritis itself is treated with an oral medication containing corticosteroids and an eye solution. In some cases, antibiotics are prescribed. Simply using eye drops will not treat scleritis. In more aggressive cases of scleritis, chemotherapy (such as systemic immunosuppressive therapy with such drugs as cyclophosphamide or azathioprine) may be used to treat the disease. If not treated, scleritis can cause blindness.

External links

• Scleritis article at StLukesEye.com
• Scleritis article at EyeMDLink.com
• Scleritis article at Merck.com

References

• Sainz de la Maza, Maite, MD, PhD "Scleritis", eMedicine.com, September 26, 2006. Accessed June 12, 2007.