Patient Basics: Scleritis

Originally published by Harvard Health.

What Is It?

Scleritis is a potentially serious inflammation of the sclera, commonly called the white of the eye. It is the tough, white tissue that gives the eye its shape and protects the eye. More than 50% of cases of scleritis are associated with another disease that affects the whole body, such as rheumatoid arthritis, or are caused by infection or injury. Scleritis occurs most often in people aged 30 to 60 and is rare in children. If left untreated, the condition can spread to parts of other parts of the eye. Some visual loss could then occur.

Symptoms

The main symptoms of scleritis are pain and redness in the white part of the eye. These symptoms usually develop gradually and eventually become severe. The redness may become an intense purple. Many people with scleritis have pain radiating from the eye to adjacent areas of the head and face. Commonly, the eye becomes teary and very sensitive to light. You may lose some vision.

Diagnosis

Your eye doctor will ask you about your medical history and conduct a thorough examination. In addition, because of the association between scleritis and other general medical conditions, your doctor may suggest a comprehensive medical examination, including blood counts and other tests and evaluations. Ultrasound, computed tomography (CT) scanning, magnetic resonance imaging (MRI), or a biopsy may be used to rule out other causes of symptoms.

Expected Duration

Depending on its cause, scleritis should begin to clear up fairly quickly once treatment begins.

Prevention

Scleritis cannot be prevented.

Treatment

Scleritis needs to be treated promptly to help avoid complications and vision loss. When related to an underlying disease, treatment of the disease may control the inflammation of the eye. Drugs used to treat scleritis include a corticosteroid solution that you apply directly to your eye, an oral corticosteroid (prednisone) and a non-steroidal anti-inflammatory drug (NSAID). More powerful medications that suppress the immune system may be needed for severe cases not responding to corticosteroids. In severe cases, surgery may be required to repair injured areas of the eyeball.

When To Call a Professional

You should call your doctor immediately if your eye is painful and red.

Prognosis

Scleritis usually responds to treatment, but the condition may return. If left untreated, scleritis can lead to perforation of the eyeball, which can cause significant loss of vision.

The long-term outlook largely depends on what caused the condition. Complications are common and can include keratitis (inflammation of the cornea), cataracts (scarring of the lens), uveitis (inflammation of the eye behind the pupil), and glaucoma (elevated pressure in the eye that may lead to vision loss).

Additional Info

American Academy of Ophthalmology
P.O. Box 7424
San Francisco, CA 94120-7424
Phone: 415-561-8500
Fax: 415-561-8533
http://www.aao.org/news/eyenet/

National Eye Institute
2020 Vision Place
Bethesda, MD 20892-3655
Phone: 301-496-5248
http://www.nei.nih.gov/