Understanding Scleritis: Causes, Symptoms, and Treatment

In today’s blog post, we’re diving deep into a specific cause of red eye: scleritis. This condition involves inflammation and redness of the sclera, which is the white part of your eye. As we discuss scleritis, we’ll be covering key aspects such as its subtypes, causes, symptoms, diagnosis, and treatment. This information is particularly useful for medical students preparing for exams like the USMLE, medical school finals, and general practice AKT.

Scleritis is a condition that can significantly impact your vision if not treated promptly. There are two main types of scleritis: anterior scleritis and posterior scleritis. Anterior scleritis is the more common type, accounting for about 98% of cases. It can be further subdivided into diffuse, nodular, and necrotizing types. Posterior scleritis, on the other hand, is much less common and affects the back of the eye. It's important to note that anterior scleritis is far more prevalent, and this is a key point to remember, especially for those preparing for medical exams.

The causes of scleritis are often linked to autoimmune diseases. However, there are instances where no known cause can be identified. Common autoimmune conditions associated with scleritis include rheumatoid arthritis, lupus, and inflammatory bowel diseases like Crohn’s disease and ulcerative colitis. Other conditions such as Sjogren’s syndrome, granulomatosis, and connective tissue disorders like scleroderma are also linked to scleritis. Though rare, trauma to the eye and parasitic or infectious causes can also lead to scleritis.

When it comes to symptoms, the most noticeable one is the redness of the sclera. Patients often experience significant pain, especially when moving their eyes. This is a critical differentiator from episcleritis, a condition with a similar name but much less associated pain. Other symptoms include tenderness of the eye, a purple hue in the sclera, blurred vision, tearing, and extreme sensitivity to light, known as photophobia. The purple hue is particularly notable and can be an important diagnostic clue.

Diagnosing scleritis involves a thorough examination by an ophthalmologist. If you or your patient exhibits symptoms of scleritis, an urgent referral to an ophthalmologist is essential. Without prompt treatment, scleritis can lead to visual loss. The ophthalmologist will likely use a slit lamp to examine both the inside and outside of the eye and may ask about the patient's overall health to identify any underlying systemic conditions. Blood tests might also be conducted to pinpoint the exact cause.

Treatment for scleritis needs to be initiated as soon as possible. The treatment plan can vary depending on the type and severity of scleritis. Common treatments include non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen to control pain and inflammation. However, caution is advised if the patient has gastric diseases or ulcers, as NSAIDs can exacerbate these conditions. Steroids are another treatment option that can help control inflammation. In cases where an underlying condition like rheumatoid arthritis is causing the scleritis, immunosuppressive drugs may be required to manage the primary disease.

In very severe cases, surgery might be needed to repair the eye and prevent further vision loss. It's crucial to treat both the scleritis and any underlying conditions to control symptoms effectively. Despite treatment, it’s important to note that scleritis may recur, so ongoing monitoring and management are essential.

I hope this comprehensive overview of scleritis has been helpful. Understanding the causes, symptoms, diagnosis, and treatment options is crucial for effective management of this condition. If you found this information useful, please explore the other videos and blog posts on this channel. Your feedback is always appreciated, so feel free to leave a comment below.

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Thank you for reading, and until next time, take care!