Scleritis: Causes, Symptoms, and Treatment
Medically reviewed by Harsha Moole, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor treats Scleritis?
An ophthalmologist, an eye doctor who treats eye diseases, usually leads care for scleritis. The ophthalmologist may work with a rheumatologist, a doctor who treats autoimmune diseases, and with your primary care doctor. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What is scleritis?
Scleritis is swelling, called inflammation, of the sclera. The sclera is the white part of the eye. When it is swollen, red, tender, or painful, doctors call it scleritis.
There are two main types. Anterior scleritis happens at the front of the eye and is more common. Posterior scleritis happens at the back of the eye and is rarer. Most people have only one type, but some have both.
Anterior scleritis has three forms. The most common form can inflame the whole sclera or one section of it. Another form causes tender bumps, called nodules, on the sclera. The most severe form can be very painful and can destroy the sclera.
Symptoms
Symptoms of scleritis include:
- Pain and tenderness of the eye
- Redness and swelling of the white part of the eye
- Blurred vision and tearing
- Extreme sensitivity to light
- Pain in the jaw, face, or head
In some cases, people lose some or all of their vision. The pain can get worse when you move your eye, and it may be worse at night. A rare form of scleritis causes no eye pain or redness.
Causes and who gets it
Scleritis is often linked with an autoimmune disease. In an autoimmune disease, the immune system attacks healthy body tissue by mistake. Sometimes there is no known cause.
Scleritis may be linked to:
- Arthritis, which is joint swelling and stiffness
- Lupus or another connective tissue disease
- Inflammatory bowel disease
- Sjogren's syndrome, which causes very dry eyes and other symptoms
- Scleroderma, an autoimmune disease that hardens the skin
- An eye infection
An injury to the eye can also cause scleritis. Rarely, a fungus or a parasite is the cause. Scleritis occurs most often in people between the ages of 30 and 60. It is rare in children. It is also more common in women.
How doctors diagnose it
An ophthalmologist looks at the inside and outside of your eye with a special microscope called a slit lamp. The doctor also asks about your overall health. Blood tests, imaging, or other tests may be needed.
The same symptoms can come from episcleritis, a milder kind of inflammation. Your doctor needs to tell the two apart. For scleritis at the back of the eye, doctors may use an ultrasound or an MRI scan.
Treatment
Scleritis needs to be treated as soon as you notice symptoms to save your vision. Treatment depends on the type of scleritis. For mild to moderate scleritis, the first choice is usually an NSAID pill. NSAIDs are medicines like ibuprofen that ease pain and swelling.
Other treatments can include:
- Steroid eye drops
- Steroid pills, which are medicines that control inflammation
- Antibiotic or antiviral pills
- Medicines that weaken or change the immune system response, used for severe scleritis
In severe cases, surgery may be needed to repair the eye and stop further vision loss. If another disease is causing the scleritis, that disease also needs treatment. Scleritis may come back, so regular visits with your eye doctor matter. Newer medicines called TNF inhibitors have shown promise in scleritis that is not caused by infection and has not improved with other treatments.
When to see a doctor
If you have symptoms of scleritis, see an ophthalmologist as soon as possible. Without treatment, scleritis can lead to vision loss. A possible complication is a hole (perforation) in the eyeball, which can lead to vision loss if scleritis is left untreated.
Call 911 or go to the emergency room if you have a sudden change in your vision.
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. Either kind of doctor can look at your symptoms and help you reach an eye doctor. They can also help coordinate care with other doctors.
Common questions
Is scleritis serious?
Yes, scleritis can be serious. Without treatment, it can lead to vision loss, so treatment should start as soon as you notice symptoms.
What causes scleritis?
Scleritis is often linked with an autoimmune disease, such as arthritis or lupus. Sometimes there is no known cause. An injury to the eye can also cause it.
Can scleritis come back?
Yes, scleritis can come back, even after treatment. In most cases, though, it goes away with treatment.
Can scleritis be prevented?
Most cases cannot be prevented. People with autoimmune diseases may need regular check-ups with an ophthalmologist who knows the condition.
Sources
- American Academy of Ophthalmology - What Is Scleritis?
- MedlinePlus - Scleritis
- American Academy of Ophthalmology - EyeWiki: Scleritis
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
