Scleritis

Question 1

What is scleritis?

Answer 1

= the inflammation of the sclera: involves the deep scleral plexus (less common but more severe than episcleritis)

Question 2

What is the cause scleritis?

Answer 2

1. Secondary to systemic diseases (50%) -> RA, inlammatory bowel disorders, Wedgener Granulomatosis
2. Secondary to infection - bacterial or viral
3. Following ocular surgery

Question 3

What are symptoms of Non-Necrotising Anterior Scleritis?

Answer 3

• Unitlateral Redness
• Pain: Gradual Onset
• Lacrimation (watering)

Question 4

What are the 2 types of signs for non-necrotising anterior scleritis?

Answer 4

1. Diffuse:
   - > Widespread inflammation
   - > Marked oedema of sclera & episcleral tissue
   - > Distortion of normal radial vessel pattern
2. Nodular:
   - > Distinct immobile nodule
   - > Localised inflammation
   - > Usually interpalpebral close to limbus

Question 5

What is the management and treatment for Non-Necrotising Anterior Scleritis?

Answer 5

URGENT REF to OP

Treatment: Systemic NSAIDs (Flurbiprofen), Systemic Corticosteroids (Predisolone)

Question 6

What is anterior necrotising with inflammation?

Answer 6

= Most severe (sight threatening) - most px have life threatening systemic vascular disease.

Question 7

What are the symptoms of anterior necrotising with inflammation?

Answer 7

• Bilateral
• Gradual onset + redness
• Pain becomes severe and persistent (after3-4days)

Question 8

What are the 3signs of anterior necrotising with inflammation?

Answer 8

1. Localised congestion of scleral vessels
2. Avascular patches
3. Necrosis (death of cells in organs) of sclera & ulceration of conjunctiva. -> that can spread to cornea, ciliary body, trabecular meshwork.