scleritis Flashcards
what is scleritis?
-inflammation of the full thickness of the sclera
what is more serious, scleritis or episcleritis?
scleritis
which part of the eye is the sclera?
-white part
what is the most severe type of scleritis?
-necrotising scleritis
what usually causes scleritis?
-may be underlying autoimmune condition
HLA B27
SLE
how does scleritis present?
- usually acute onset
- 50% cases are bilateral
- severe pain
- pain with eye movement
- photophobia
- eye watering
- reduced visual acuity
- abnormal pupil reaction to light
- tenderness to palpation of the eye
Violaceous hue (violet/blue) -Injection of deep vascular plexus
what colour may the eye go if a patient has scleritis?
- very red
- may have a violaceous hue (violet/blue)
what is the management for scleritis?
-same day assessment by an opthamologist
- consider underlying systemic condition
- NSAIDs (topical/systemic)
- steroids (topical/systemic)
- immunosuppression if appropriate (e.g. methotrexate for RA)
what is the episclera?
the thin layer of tissue that lies between the conjunctiva and the connective tissue layer that forms the white of the eye (sclera)
who does episcleritis commonly affect?
- young and middle aged adults
- often associated with RA and IBD
how does episcleritis present?
- usually presents with acute onset unilateral symptoms
- typically not painful but there can be mild pain
- segmental redness (rather than diffuse)
- foreign body sensation
- dilated episceral vessels
- watering eye
- no discharge
what is the management of scleritis?
- episcleritis is usually self limiting and will recover in 1-4 weeks
- in mild cases no treatment is necessary, lubricating eye drops can help symptoms
- simple analgesia, cold compression and safety net advice are appropriate
