Inflammation of the sclera, the white outer layer of the eye, can cause pain, redness, and vision problems if left untreated. Scleritis is a rare but serious condition. Throughout this article, we will examine scleritis' causes, symptoms, diagnosis, treatment, and prevention.
Causes
There is no clear cause of scleritis, but it is often associated with autoimmune diseases like rheumatoid arthritis, lupus, or inflammatory bowel disease. Infections, trauma, exposure to irritants, or certain medications may also cause scleritis. Other eye conditions such as uveitis and keratitis may also cause scleritis.
Symptoms
Depending on the severity and location of inflammation, scleritis may cause the following symptoms:
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Deep or throbbing eye pain
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Swelling and redness of the eye, particularly in the sclera
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Vision blurring or changes in clarity
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Light sensitivity (photophobia)
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Eye discharge or tears
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Inflammation of nearby structures can cause headaches or facial pain
Diagnosis
An ophthalmologist or eye specialist can diagnose scleritis by performing a comprehensive eye examination. Diagnostic procedures may include:
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Symptoms, medical history, and any underlying health conditions or medications that may contribute to scleritis will be discussed with a healthcare provider.
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Examination of the eye may be necessary to assess the extent and severity of inflammation, including visual acuity testing, intraocular pressure measurement, and assessment of the anterior and posterior segments of the eye.
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The layers of the eye can be visualized with imaging techniques such as ultrasound or optical coherence tomography (OCT) to assess for signs of scleral thinning or complications such as choroidal effusion or retinal detachment.
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A blood test may be ordered to evaluate for underlying systemic diseases or autoimmune conditions associated with scleritis, such as rheumatoid factor, antinuclear antibodies (ANA), or C-reactive protein (CRP).
Treatment
Scleritis can be treated by reducing inflammation, alleviating symptoms, and preventing complications. Treatment options include:
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NSAIDs, corticosteroids, or immunosuppressive medications may be prescribed to reduce inflammation and pain associated with scleritis on a topical or oral basis. A topical steroid eye drop or ointment may be used for localized inflammation, whereas an oral medication may be necessary for more severe or widespread inflammation.
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In cases of severe or refractory scleritis, immunosuppressive medications such as methotrexate, cyclosporine, or azathioprine are prescribed to suppress the immune response.
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Scleritis can be treated with biologic therapies such as tumor necrosis factor (TNF) inhibitors or interleukin-6 (IL-6) inhibitors.
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To reinforce the weakened sclera and prevent complications in cases of scleromalacia perforans or necrotizing scleritis with impending scleral rupture, surgical intervention such as scleral grafting or amniotic membrane transplantation may be necessary.
Prevention
Managing underlying systemic diseases or autoimmune conditions that predispose individuals to scleral inflammation is crucial to preventing scleritis. It is crucial that patients with autoimmune disorders work closely with their healthcare providers to manage and monitor their condition effectively. You can also lower your risk of scleritis by practicing good eye hygiene, avoiding trauma or injury, and responding promptly to ocular symptoms.
