Sclera

Question 1

Sclera start and end point

Answer 1

Starts at the limbus anteriorly
and terminates at the optic nerve posteriorly

Question 2

What are the three parts of the sclera?

Answer 2

1. Episclera (outermost): Thin vascularized connective tissue anterior to the sclera and posterior to the Tenon capsule.
2. Substantia propria: Made of irregularly arranged type I collagen fibrils.
3. Lamina fusca (innermost): Made of loosely arranged connective tissue and
   separated from the choroid by the suprachoroidal space

Question 3

Innervation of sclera

Answer 3

Anterior sclera: Long posterior ciliary nerve

Posterior Sclera: Short posterior ciliary nerve

Question 4

What is Episcleritis?

Answer 4

Episcleritis (inflammation of the episclera) is a common self-limiting condition which typically affects middle-aged females. It is usually idiopathic

Question 5

Investigation of Episcleritis

Answer 5

Instillation of 10% phenylephrine blanches the redness in episcleritis.

Question 6

Management of Episcleritis

Answer 6

Cool compresses and oral nonsteroidal anti-inflammatory drugs (NSAIDs)

Question 7

What is Scleritis?

Answer 7

Full-thickness inflammation of the sclera, most commonly associated with autoimmune diseases

Question 8

Conditions associated with Scleritis

Answer 8

Rheumatoid arthritis (RA): The most common systemic association
of scleritis. (Note: The most common ocular manifestation of RA is
keratoconjunctivitis sicca.)
● Granulomatosis with polyangiitis.
● Polyarteritis nodosa.
● Relapsing polychondritis.
● Infection: Herpes zoster, Lyme disease, syphilis, etc.

Question 9

Scleritis management

Answer 9

Instillation of 10% phenylephrine does not blanch vessels in scleritis.
● Oral NSAIDs for mild-moderate scleritis.
● Systemic steroids and/or other immunomodulatory therapy for severe or
necrotizing scleritis.

Question 10

Blue sclera causes

Answer 10

Osteogenesis Imperfecta

Ehlers-Danlos syndrome