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.

Rarely, inflammation is severe enough to cause a hole to form in the eyeball (perforation) and loss of the eye. Such severe inflammation is called necrotizing scleritis. People who have necrotizing scleritis often have many years of problems such as autoimmune disorders (for example, 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 , granulomatosis with polyangiitis Granulomatosis with Polyangiitis Granulomatosis with polyangiitis often begins with inflammation of small- and medium-sized blood vessels and tissues in the nose, sinuses, throat, lungs, or kidneys. The cause is unknown. The... read more , polyarteritis nodosa Polyarteritis Nodosa (PAN) Polyarteritis nodosa is a form of vasculitis involving inflammation of medium-sized arteries. Any organ can be affected but usually not the lungs. Polyarteritis nodosa can be rapidly fatal or... read more , and relapsing polychondritis Relapsing Polychondritis Relapsing polychondritis is a rare autoimmune connective tissue disorder characterized by episodes of painful, destructive inflammation of the cartilage and other connective tissues in many... read more ) in other organs of the body.

Doctors diagnose scleritis by its symptoms and appearance during a slit-lamp examination Slit-Lamp Examination A person who has eye symptoms should be checked by a doctor. However, some eye disorders cause few or no symptoms in their early stages, so the eyes should be checked regularly (every 1 to 2... read more . Sometimes the area of inflammation is in the back part of the eye (posterior scleritis), and ultrasonography Ultrasonography Ultrasonography uses high-frequency sound (ultrasound) waves to produce images of internal organs and other tissues. A device called a transducer converts electrical current into sound waves... read more or a computed tomography Computed Tomography (CT) In computed tomography (CT), which used to be called computed axial tomography (CAT), an x-ray source and x-ray detector rotate around a person. In modern scanners, the x-ray detector usually... read more (CT) scan is needed to confirm the diagnosis of posterior 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. About 50% of people with necrotizing scleritis die within 10 years, often due to a heart attack.

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.