Anterior Scleritis Flashcards
Two types of scleritis
Diffuse- inflammation of the anterior sclera involving the deep episcleral plexus.**more common
Nodular: with an associated nodule.
Etiologyy/associations of anterior scleritis
Idiopathic in 40% of cases
Collagen vascular disease in 50% of cases. Such as RA, SLE, GPA, and PAN.
Symptoms of anterior scleritis
Red eyes
Severe, deep, boring pain. Awakens patient at night, may radiate to adjacent facial regions, worsens during eye movement, may have tearing.
Signs of scleritis
Scleral injection- usually sectoral but could be diffuse.
Scleral vessels are large, deep vessels that cannot be moved with a cotton swab and do not blanch.
Chemosis (edema)
**Scleral is violaceous in color (violet to light red hue) due to inflammation in deeper tissues.
Immobile nodule in nodular scleritis.
With recurrent episodes, may see areas of scleral thinning. Appears blue grey
Why can the sclera appear blue-grey?
With recurrent episodes, you may see scleral thinning.
Complications of scleritis
Inflammation of adjacent cornea (peripheral keratitis)
Glaucoma secondary to increase IOP
How to manage non-infectious scleritis?
Oral NSAIDs. Several may be tried before therapy is considered a failure.
Could try steroids, IV steroids for severe cases, immunosuppressants for long term therapy.
Most common type of scleritis
Diffuse
How long can scleritis last?
Months of years
What is the most common systemic association of scleritis?
RA
If associated with other orbital inflammation, it could be part of ___
Orbital pseydotumor
Does scleritis respond well to topical therapy?
Not usually. However, durezol, a topical steroid has been shown to work in mild cases.
