Scleritis/ episcleritis Flashcards
define scleritis
involves inflammation of the full thickness of the sclera
how is scleritis differnt to episcleritis
more serious than episcleritis and is not usually caused by infection
most severe type of scleritis
necrotising scleritis
what can necrotising scleritis lead to
perforation of the sclera
assoc systemic conditions to scleritis 5
around 50% of ptx have assoc condition
-RA
-SLE
-IBD
-Sarcoidosis
-Granulomatossi with polyangitis
presentatation of scleritis 7
severe pain
pain with eye movement
photophobia
eye watering
reduced visual acuity
abnormal pupil reaction to light
tenderness to palpation of the eye
how can necrotising scleritis differ in presentaiton to scleritis 1
most patients will have visual impairment but not have any pain
management of scleritis 4
as it is a paingul red eye it should be referred for same day assessment by ophthal
consider and treat underlying systemic condition (immunosuppression)
NSAIDs-topical or systemic
Steroids- topical or systemic
define episcleritis
benign and self-limitng inflammation of the episclera
episclera-outermost layer of the sclera
-situated just underneath the conjunctiva
who gets episcleritis
common in young and middle aged adults
-not usually caused by infection
often assoc w inflammatory disorders like RA and IBD
presentation of episcleritis 7
usually acute onset unilateral syx
typically not painful but may have mild pain
segmental redness (rather than diffuse)
-usually patch of redness in lateral sclera
foreign body sensation
dilated episcleral vessels
watering of eye
no discharge
management of episcleritis 4
if doubt for dx- refer to ophthal
usually self limiting
-recover in 1-4wks
mild cases- no treatment
-lubricating eye drops may help syx
analgesia
cold compresses
safteynet advice
severe- systemic NSAIDs or topical steroid eye drops
