Merck Manual

Please confirm that you are not located inside the Russian Federation

honeypot link

Scleritis

By

Zeba A. Syed

, MD, Wills Eye Hospital

Reviewed/Revised Apr 2023
VIEW PROFESSIONAL VERSION
GET THE QUICK FACTS
Topic Resources

Scleritis is severe, destructive inflammation of the sclera (the tough, white, fiber layer covering the eye) that may threaten vision.

  • Scleritis sometimes occurs in people who have a bodywide inflammatory disease.

  • The main symptom is a deep, painful ache in the eye.

  • Sometimes imaging tests are done to confirm the diagnosis.

  • Treatment typically begins with corticosteroids.

Scleritis is most common among women aged 30 to 50. In one third of cases, it affects both eyes. Scleritis may accompany rheumatoid arthritis Rheumatoid Arthritis (RA) Rheumatoid arthritis is an inflammatory arthritis in which joints, usually including those of the hands and feet, are inflamed, resulting in swelling, pain, and often destruction of joints.... read more Rheumatoid Arthritis (RA) , systemic lupus erythematosus Systemic Lupus Erythematosus (SLE) Systemic lupus erythematosus is a chronic autoimmune inflammatory connective tissue disorder that can involve joints, kidneys, skin, mucous membranes, and blood vessel walls. Problems in the... read more Systemic Lupus Erythematosus (SLE) , or another autoimmune disorder Autoimmune Disorders An autoimmune disorder is a malfunction of the body's immune system that causes the body to attack its own tissues. What triggers an autoimmune disorder is not known. Symptoms vary depending... read more (a malfunction of the body's immune system Overview of the Immune System The immune system is designed to defend the body against foreign or dangerous invaders. Such invaders include Microorganisms (commonly called germs, such as bacteria, viruses, and fungi) Parasites... read more that causes the body to attack its own tissues). About half of the cases of scleritis have no known cause. (See also Overview of Conjunctival and Scleral Disorders Overview of Conjunctival and Scleral Disorders The conjunctiva is the membrane that lines the eyelid and loops back to cover the sclera (the tough white fiber layer covering the eye), right up to the edge of the cornea (the clear layer in... read more .)

An Inside Look at the Eye

An Inside Look at the Eye

Symptoms of Scleritis

Symptoms of scleritis include pain in the eye (typically a deep ache) that is often constant and severe enough to interfere with sleep and reduce appetite. Other symptoms include eye tenderness, increased watering of the eye, and sensitivity to bright light. Redness that is purplish in color occurs over part or all of the eye.

Diagnosis of Scleritis

Treatment of Scleritis

  • Corticosteroids

  • Sometimes immunosuppressants

  • Sometimes surgical repair

To treat scleritis, doctors usually give corticosteroids taken by mouth (such as prednisone). Very rarely, nonsteroidal anti-inflammatory drugs taken by mouth are enough treatment for mild cases. If the person has an autoimmune disorder Autoimmune Disorders An autoimmune disorder is a malfunction of the body's immune system that causes the body to attack its own tissues. What triggers an autoimmune disorder is not known. Symptoms vary depending... read more or does not respond to corticosteroids, drugs that suppress the immune system (immunosuppressants), such as methotrexate, cyclophosphamide, or rituximab, may be needed.

People who are at risk of a perforation may need surgical repair.

Prognosis for Scleritis

About 14% of people who have scleritis develop significant decrease in vision within 1 year, and 30% develop significant decrease in vision within 3 years.

Drugs Mentioned In This Article

Generic Name Select Brand Names
Deltasone, Predone, RAYOS, Sterapred, Sterapred DS
Jylamvo, Otrexup, Rasuvo, RediTrex, Rheumatrex, Trexall, Xatmep
Cyclophosphamide, Cytoxan, Neosar
RIABNI, Rituxan, RUXIENCE, truxima
NOTE: This is the Consumer Version. DOCTORS: VIEW PROFESSIONAL VERSION
VIEW PROFESSIONAL VERSION
quiz link

Test your knowledge

Take a Quiz!
iOS ANDROID
iOS ANDROID
iOS ANDROID
TOP