Scleritis

Scleritis is a serious eye inflammation that affects the white outer layer of the eye called the sclera. This painful eye condition can cause severe eye redness, discomfort, and even vision problems if left untreated.

Recognizing the signs and symptoms of scleritis is key for early diagnosis and proper treatment. Eye pain, tenderness, and redness are common indicators of this inflammatory condition.

Understanding scleritis and seeking prompt medical attention can help prevent complications and preserve eye health. With the right care and management, individuals with scleritis can find relief from their symptoms and maintain clear vision.

What is Scleritis?

Scleritis is a painful inflammation of the sclera, the white outer layer of the eye. It causes redness, swelling, and tenderness. If not treated, it can also affect vision.

The sclera is key in keeping the eye’s shape and protecting its inner parts. When it gets inflamed, it can hurt and disrupt the eye’s function. Scleritis often happens with autoimmune disorders like rheumatoid arthritis or lupus.

The table shows the eye’s main parts and what they do. When the sclera gets inflamed, it can upset the eye’s balance. Knowing the eye’s anatomy helps spot scleritis signs and get medical help fast.

Symptoms of Scleritis

Scleritis is a serious condition that affects the white outer layer of the eye, called the sclera. It can cause many symptoms that need quick medical help. Knowing the signs of scleritis is key for early diagnosis and treatment.

Eye Pain and Tenderness

Eye pain is a major symptom of scleritis. People often say the pain feels like deep, severe aching or burning. It can spread to the brow, cheek, or jaw. The eye also gets tender, making it hard to touch gently.

Redness and Swelling

Scleritis makes the eye look red, often with a deep, purplish color. This redness comes from blood vessels getting bigger in the sclera due to inflammation. Swelling can also happen, making the eye look slightly bulging or elevated.

Vision Changes

Scleritis can also affect vision. Some people see things less clearly, have blurred vision, or even see double. These vision problems happen when inflammation hits nearby eye parts, like the cornea or uvea. If vision changes happen with eye pain and redness, see an eye doctor right away.

The severity and mix of symptoms can vary. Some people feel more pain, while others see more redness or swelling. If you think you or someone you know might have scleritis, get medical help fast. This is to avoid serious problems and keep the eyes healthy.

Types of Scleritis

Scleritis is divided into two main types: anterior and posterior scleritis. Each type has its own symptoms and risks. Getting a quick diagnosis and treatment is key to avoid losing vision.

Anterior Scleritis

Anterior scleritis impacts the front part of the sclera, which is the white part of the eye. It’s more common than posterior scleritis and can be diffuse, nodular, or necrotizing. Symptoms include:

• Severe, deep eye pain that may radiate to the face, brow, or jaw
• Redness and swelling of the sclera
• Sensitivity to light (photophobia)
• Tearing and blurred vision

Necrotizing anterior scleritis is the most severe. It causes the scleral tissue to thin and die. This can lead to serious problems like scleral perforation and vision loss if not treated.

Posterior Scleritis

Posterior scleritis affects the back part of the sclera, which is not visible. It’s less common but harder to diagnose. Symptoms include:

• Deep, aching eye pain that may worsen with eye movement
• Reduced visual acuity or double vision
• Swelling and redness of the eyelid or conjunctiva
• Tenderness of the eye upon gentle pressure

Posterior scleritis can lead to serious issues like retinal detachment and optic disc swelling. It might also be linked to diseases like rheumatoid arthritis.

It’s important to tell the difference between anterior and posterior scleritis to choose the right treatment. An eye doctor will do a detailed exam and might use tests like ultrasound or MRI to see the affected areas.

Causes of Scleritis

Scleritis can be caused by many factors, with autoimmune disorders being the most common. In fact, up to 50% of scleritis cases are linked to an underlying autoimmune condition. Rheumatoid arthritis is a big culprit, affecting about 20-30% of those with scleritis.

Other autoimmune disorders that may trigger scleritis include:

Scleritis can also be caused by infections like tuberculosis, herpes zoster, or syphilis. Eye injuries or surgeries can sometimes lead to it, though this is rare. Certain medications, like bisphosphonates for osteoporosis, can also cause scleritis.

In about 30-40% of cases, the cause of scleritis is unknown. This is called idiopathic scleritis. Finding the cause is key to choosing the right treatment and managing any related conditions.

Diagnosing Scleritis

Getting a correct diagnosis for scleritis is key to treating it well. Doctors use different methods to spot scleritis and rule out other eye problems.

Physical Examination

The first thing doctors do is a detailed eye check. They look at the sclera for redness, swelling, and tenderness. They also check your vision and how well you can see.

Imaging Tests

To understand scleritis better, doctors might use imaging tests. These include:

These tests help doctors see inside the eye. They spot inflammation or damage that’s hard to see by eye alone.

Blood Tests

Sometimes, scleritis is linked to autoimmune diseases. Blood tests can find these diseases. They look for antibodies or inflammatory markers that show these conditions.

Doctors use a physical exam, imaging tests, and blood tests to diagnose scleritis. This helps them choose the right treatment. Early action is important to avoid vision problems.

Treatment Options for Scleritis

Effective treatments for scleritis aim to reduce inflammation and manage symptoms. The right treatment depends on the type and severity of scleritis, and the cause. It’s important to work closely with a healthcare provider to find the best approach for you.

The main treatment options for scleritis include:

Anti-Inflammatory Medications

Non-steroidal anti-inflammatory drugs (NSAIDs) are often the first choice for mild scleritis. These drugs help lower inflammation and ease pain. Common NSAIDs for scleritis are:

Immunosuppressive Drugs

For severe scleritis or when it’s linked to an autoimmune disorder, immunosuppressive drugs may be needed. These drugs calm down the immune system to reduce inflammation. Examples include methotrexate, cyclosporine, and mycophenolate mofetil.

Corticosteroid Therapy

In cases where other treatments don’t work, corticosteroids might be used to quickly reduce inflammation. They can be taken orally, applied topically, or injected. But, long-term use can cause side effects like cataracts, glaucoma, and infections.

Your healthcare provider will keep an eye on how you’re doing and adjust your treatment as needed. Regular check-ups are key to making sure the treatment is working and to avoid complications.

Complications of Untreated Scleritis

Not treating scleritis can cause serious complications that harm your eye health and vision. Untreated scleritis can damage your eye a lot. This might lead to vision loss and other serious ocular diseases.

Some serious problems that can happen if scleritis is not treated include:

To avoid these serious complications and keep your eyes healthy, get medical help right away if you think you have scleritis. Early treatment can control inflammation. It can also help prevent vision loss and other ocular diseases.

Living with Scleritis

Living with scleritis can be tough, but there are ways to manage it. Using warm compresses, wearing sunglasses, and eye drops can help. Activities like meditation, gentle exercise, and spending time with loved ones also boost your mood.

Regular eye check-ups are key to keeping scleritis under control. Your eye doctor will watch your condition and adjust treatments as needed. Always keep your appointments and tell your doctor about any changes in your symptoms.

Finding Support

Connecting with others who have scleritis can be really helpful. Look for local support groups or online forums. Sharing your story and learning from others can make you feel less alone and more supported.

With the right care, coping strategies, and support, you can live a full life with scleritis. Stay active in your treatment, take care of yourself, and ask for help when you need it. By working with your healthcare team and staying positive, you can overcome the challenges of scleritis.