SCLERITIS

INFLAMMATION OF SCLERA

NON-INFECTIOUS

1. RHEUMATOID ARTHRITIS (MOST COMMON ASSOCIATION)

2. SARCOIDOSIS

3. SLE

4. WEGENER GRANULOMATOSIS

5. GOUT

INFECTIOUS 

1. HERPES ZOSTER 

2. TUBERCULOSIS

3. SYPHILIS

I. Anterior scleritis

• Nodular

• Diffuse

• Necrotizing

– With inflammation

– Without inflammation

II. Posterior scleritis

1. SYMPTOMS

   1. PAIN (TEARS)

   2. REDNESS

   3. SWELLING

   4. LOSS OF FUNCTION THAT IS VISION 

2. SIGNS

   1. TENDERNESS (LACRIMATION)

   2. CONGESTION

   3. EDEMA

   4. REDUCED VISUAL ACUITY

BASELINE :

1.  CBC

2. ESR

3. X-RAY CHEST

CONFIRM YOUR DIAGNOSIS

1. RA->RA FACTOR

2. TB->MOUNTEX TEST

3. SYPHILIS-> VDRL,  FTA ABS

4. SARCOIDOSIS-> SERUM ACE

5. GOUT -> SERUM ACE

TREAT THE CAUSE

FOR EXAMPLE RHEUMATOID ARTHERITIS 

TREAT SYMTPOMS

PAIN KILLERS

ANTI-INFLAMMATORY AGENTS

NON-STEROID

TOPICAL

NEPAFENAC EYE DROPS

ORAL

BRUFEN TABLETS 

STEROIDS

TOPICAL 

MILD STEROIDS LIKE FLOUROMETHALONE EYE DROPS

POTENT STEROIDS LIKE PREDNISOLONE EYE DROPS

ORAL

TABLET PREDNISONE 

TREAT COMPLICATIONS

FOR EXAMPLE UVEITS 

EPISCLERITIS

1. LESS PAIN 

2. LESS REDNESS

3. LESS SWELLING

4. NO VISUAL LOSS

5. NO COMPLICATIONS

6. NO BLUISH COLOR ON LESION

7. BLANCH WITH 10 % PHENYLEPHRINE (VASOCONSTRICTOR) EYE DROPS

SCLERITIS

1. MORE PAIN

2. MORE REDNESS

3. MORE SWELLING

4. MORE VISUAL LOSS 

5. COMPLICATIONS

6. BLUISH COLOR ON LESION

7. BLANCH WITH 10 % PHENYLEPHRINE (VASOCONSTRICTOR) EYE DROPS

• PROGRESSIVE SCLERAL THINING WITHOUR PERFORATION 

• COMMONLY SEEN IN OLD AGE WOMEN 

• WITH LONG STANDING RHEUMATOID ARTHERITIS 

CLINICAL FEARTURES

1. NECROTIC AREAS

2. SCLERAL THINNING

3. EXPOSURE OF UNDERLYING UVEA

4. NO PAIN

5. NO VISUAL LOSS

6. NO VASCULAR CONGESTION

TREATMENT

TREAT THE CAUSE

TREAT SYMPTOMS

1. LUBRICANT EYE DROPS

2. SYSTEMIC ANTICOLLAGENASES

3. TOPICAL AND ORAL STEROIDS

4. TOPICAL CYCLOSPORIN

TREAT COMPLICATIONS

SURGICAL REPAIR OF SCLERAL PERFORATION

PROTECTION FROM TRUAMA