Scleritis

Question 1

The episclera is the layer of the eye, above (epi) the sclera and below the conjunctiva. If this layer becomes inflamed, it is referred to as Episcleritis. Typically idiopathic, but what other condition is it associated with?

1 - T1DM
2 - osteoarthritis
3 - RA
4 - T2DM

Answer 1

3 - RA

Linked with collagen- vascular conditions such as rheumatoid arthritis

Most common cause is idiopathic

Question 2

In Episcleritis, patients can present with a red eye. Is this a systemic red eye or a focal point?

Answer 2

• focal point

Typically the medial OR lateral aspect

Question 3

In Episcleritis, patients can present with a focal red eye. Does this cause significant pain?

Answer 3

• no

This is typically self-limiting

Question 4

Which 2 of the following can be used to treat Episcleritis?

1 - paracetamol
2 - topical anti inflammatories
3 - steroids
3 - prostaglandins

Answer 4

2 - topical anti inflammatories
3 - steroids

Normally used to expedite its recovery, but patients typically experience it again

Question 5

Scleritis is inflammation of the deeper layer of sclerla. Does scleritis cause red eye and pain?

Answer 5

• yes

Causes an extremely red and painful eye

Question 6

Scleritis causes an extremely red and painful eye. It can also cause all of the following EXCEPT which one?

1 - symptoms worse when lying
2 - boring but extreme pain
3 - problems sleeping due to pain
4 - all of the above

Answer 6

4 - all of the above

Pain when lying is due to the swelling, which moves with gravity when lying down and stretches the pain receptors

Question 7

Scleritis is associated with connective tissue disorders, BUT which is the most common?

1 - dermatomyosis
2 - lupus
3 - scleroderma
4 - RA

Answer 7

4 - RA

Patients must be investigated to identify the cause and to treat this and not just the symptoms, of which scleritis is one of

Question 8

Treatment for scleritis requires immunosuppression, but which of the following is the 1st line?

1 - steroids
2 - analgesics
3 - disease-modifying anti-rheumatic
drugs
4 - aminosalicylic acid

Answer 8

1 - steroids

Question 9

Patients with scleritis typically have an underlying condition, meaning they will need immunosuppression, of which steroid is 1st line. What is the main complication of steroid use in the sclera?

1 - fibrosis
2 - thinning of sclera
3 - clouding of the sclera
4 - all of the above

Answer 9

2 - thinning of sclera

Choriod eventually becomes visible