Scleritis Flashcards
What is scleritis?
Scleritis describes full-thickness inflammation of the sclera, generally with a non-infective cause, causing a red, painful eye.
What are the risk factors for scleritis?
Risk factors include rheumatoid arthritis, systemic lupus erythematosus, sarcoidosis, and granulomatosis with polyangiitis.
What are the clinical features of scleritis?
Features include a red eye, classically painful (with dull pain exacerbated by eye movements), watering, photophobia, and gradual decrease in vision.
What is the management for scleritis?
Management includes same-day assessment by an ophthalmologist, oral NSAIDs as first-line treatment, oral glucocorticoids for severe cases, and immunosuppressive drugs for resistant cases.
What is the key difference between episcleritis and scleritis?
Scleritis is painful, while episcleritis is painless.
What are the classic symptoms of scleritis?
A red eye and deep boring pain, with pain on eye movement.
Which connective tissue disease is scleritis most commonly associated with?
Rheumatoid arthritis.
What distinguishes scleritis from episcleritis?
Topical vasoconstrictors like 10% phenylephrine do not cause blanching of the eye in scleritis.
What is the potential consequence of untreated scleritis?
Scleritis can lead to perforation of the globe and reduced visual acuity.
What should be done if global perforation is suspected in scleritis?
The eye should be shielded and palpation avoided, with urgent evaluation by an ophthalmologist.
What laboratory tests are relevant in the evaluation of scleritis?
FBC, urea and electrolytes, erythrocyte sedimentation rate, CRP, rheumatoid factor, and c-ANCA.
What is the NICE guideline for referring suspected scleritis?
Refer people urgently (within 24 hours) to the local eye clinic if they have suspected scleritis.
