Scleritis

Question 1

What is scleritis?

Answer 1

Inflammation of the sclera

The sclera is the outer layer of connective tissue surrounding most of the eye, forming the visible white part.

Question 2

What is the most severe form of scleritis?

Answer 2

Necrotising scleritis

Necrotising scleritis can lead to perforation of the sclera.

Question 3

What are the possible aetiologies of scleritis?

Answer 3

• Idiopathic
• Associated with systemic inflammatory conditions such as:
* Rheumatoid arthritis
* Vasculitis (especially granulomatosis with polyangiitis)
* Systemic lupus erythematosus
* Sarcoidosis

Connective tissue of the sclera is similar to connective tissue in joints, which may be affected in inflammatory conditions like RA.

Question 4

What is a common clinical feature of scleritis?

Answer 4

• Gradual onset
• Red, inflamed sclera
• Congested vessels
• Severe (boring) pain
• Pain with eye movement
• Photophobia
• Epiphora (excess tears)
• Reduced visual acuity
• Tenderness to palpation of the eye

Scleritis can be unilateral or bilateral.

Question 5

What is the recommended management for scleritis?

Answer 5

• Urgent assessment in secondary care
• NSAIDs
• Steroids
• Immunosuppression (e.g. methotrexate in RA)
• Antimicrobials (if infective cause)

Management may vary based on the underlying cause and severity.

Question 6

True or False: Scleritis can be unilateral.

Answer 6

True

Question 7

Fill in the blank: The sclera is the outer layer of connective tissue surrounding most of the eye, excluding the _______.

Answer 7

cornea