Scleritis (cont.)
Andrew A. Dahl, MD, FACS
Andrew A. Dahl, MD, is a board-certified ophthalmologist. Dr. Dahl's educational background includes a BA with Honors and Distinction from Wesleyan University, Middletown, CT, and an MD from Cornell University, where he was selected for Alpha Omega Alpha, the national medical honor society. He had an internal medical internship at the New York Hospital/Cornell Medical Center.
William C. Shiel Jr., MD, FACP, FACR
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
In this Article
- Scleritis facts
- What is scleritis?
- What is the sclera?
- What causes scleritis?
- What are risk factors for scleritis?
- What are symptoms of scleritis?
- What are signs of scleritis?
- How is scleritis diagnosed?
- What is the treatment for scleritis?
- What are the complications of scleritis?
- What is the prognosis for scleritis?
- Can scleritis be prevented?
- What research is being done on scleritis?
- Find a local Doctor in your town
What is the treatment for scleritis?
Treatment of scleritis resulting from an underlying disease process usually requires specific therapy for that disease.
Topical treatment with eye drops is an adjunct to such systemic treatment. These eye drops will usually be anti-inflammatory, such as topical steroid drops or topical nonsteroidal anti-inflammatory drops (NSAIDs). Topical antibiotics are used if the scleritis is felt to be infectious.
In situations where no underlying disease process is found, eye drops to counter inflammation are used, but they are often insufficient to control the process. Systemic treatment with NSAIDs, cortisone medication (corticosteroids), or immune modulating agents such as methotrexate (MTX) can be the first choice. But azathioprine, mycophenolate mofetil, cyclophosphamide, or cyclosporine are also used. Anti-TNF agents such as the biologics infliximab (Remicade) or adalimumab (Humira) can also be used.
Localized, subconjunctival steroid injections are often helpful in certain situations or if systemic side effects of these drugs are of concern.
Rarely, surgical procedures may be required if there is scleral thinning. In order to preserve the integrity of the eye, scleral grafts available through eye banks can be used. Corneal tissue may also be used if there is perforation or severe thinning in the limbal area.
What are the complications of scleritis?
Complications of scleritis include inflammation of the cornea (keratitis), anterior or posterior uveitis, glaucoma, cataract, retinal swelling, scleral thinning, peripheral corneal shinning, and retinal macular swelling.
Corneal or scleral thinning, if untreated, may lead to a hole in the side of the eye (ocular perforation) and severe vision loss or blindness. Scleritis may be recurrent. Long-term treatment with corticosteroid eye drops may itself cause cataract and glaucoma.
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