Scleritis: presentations, disease associations and management

Postgrad Med J. 2012 Dec;88(1046):713-8. doi: 10.1136/postgradmedj-2011-130282. Epub 2012 Sep 12.

Abstract

Scleritis is a serious inflammatory condition that is often painful, and in severe cases can result in permanent loss of vision. Approximately half the patients affected have no identifiable cause, but 30%-40% have an underlying systemic autoimmune condition. Scleritis may be the initial manifestation of Wegener's granulomatosis or rheumatoid arthritis, and all patients with scleritis require a thorough systemic evaluation. Scleritis has a variable presentation and disease course, and may be an acute monophasic illness, a relapsing remitting process, or take a chronic course. Treatment options include local therapy with subconjunctival steroid injections for non-necrotising scleritis, and systemic anti-inflammatory or immunosuppressive therapy. Biologic agents have been used with success in some refractory cases. Ocular and systemic morbidity is reduced by timely treatment with immunosuppressant medications.

Publication types

  • Review

MeSH terms

  • Anti-Inflammatory Agents / therapeutic use
  • Arthritis, Rheumatoid / complications
  • Arthritis, Rheumatoid / drug therapy
  • Granulomatosis with Polyangiitis / complications
  • Granulomatosis with Polyangiitis / drug therapy
  • Humans
  • Immunosuppressive Agents / therapeutic use
  • Scleritis / complications
  • Scleritis / drug therapy*
  • Scleritis / etiology*

Substances

  • Anti-Inflammatory Agents
  • Immunosuppressive Agents