Scleritis

Question 1

Risk factors of Scleritis (9)

Answer 1

Systemic condition

1) Rheumatoid arthritis
2) Systemic lupus erythematosus
3) Polyarteritis nodosa
4) Inflammatory bowel disease
6) syphilis
7) sarcoidosis, TB

Other causes

1) Herpes zoster
2) truma/ sx

Question 2

Symptoms - Scleritis (8)

Answer 2

1) Pain moderate/ severe
2) Distrubs sleep
3) Gradual onset
4) Tenderness of globe
5) Photophobia
6) Epiphora
7) Visual loss
8) POH

Question 3

Signs of Scleritis

Answer 3

Non-necrotising

1) unilateral
2) hyperaemia- superficial + episcleral vessels ( no balancing with phenylephrine 2.5%)
3) Anterior uvetis present

4) chorodial pigment = shows thinned sclera = blue/ black coloured
5) diffuse / nodular

Necrotising

1) Sever - (75 % will eventually have visual impairment)
2) Avascular patches, sclera melting

Posterior scleritis

1) white eye
2) sclera posterior to ora serrata

Question 4

Ophthalmologist Management

Answer 4

1) Systemic cause investigated
2) NSAID
3) Topical steriod
4) Systemic Immunosupression

5) referral to Rheumatologist

Question 5

Referral for Scleritis

Answer 5

SAME DAY