- Scleritis is an uncommon disorder.
- Characterised by cellular infiltration, destrucyion of collagen & vascular remodelling.
- Bilateral disease.
- Occurs most frequently in women.
- Rheumatoid arthritis is the most common association.
- Other important causes are PAN, SLE, Ankylosing, Wegener’s granulomatosis, Dermatomyositis, Reiter’s syndrome, Non-specific arteritis, Polychondritis & Gout.
I ANTERIOR SCLERITIS (98%)
1. Non-necrotising scleritis (85%)
- Diffuse- Diffuse scleritis is widespread inflammation of the sclera, and the most common type.
- Nodular- Nodular scleritis is characterized by a localized area of inflammation where a distinct nodule can be seen.
2. Necrotising scleritis (13%)
- With inflammation- frequently associated with collagen vascular disorders causing destruction of the sclera.
- Without inflammation (Scleromalacia perforans)– very rare form of scleritis presenting with no symptoms.
II. POSTERIOR SCLERITIS (2%)
- Posterior scleritis can also be nodular or diffuse and necrotizing, and involves the sclera posterior to the insertion of the rectus muscles.
- Patients complain of moderate to severe pain which is deep & boring in character.
- Ocular pain radiates to the jaw & temple.
- Associated with localised or diffuse redness, mild to severe photophobia & lacrimation.
- Ocassionally occurs diminution of vision.
- Complications are common in necrotising scleritis & include sclerosing keratitis, keratolysis, complicated cataract, Uveitis & seconday glaucoma.
- Scleritis may also cause retinal detachment & macular edema.
- These are due to spread of inflammation from sclera into the uveal tract.
- Most common type of scleritis is Non-necrotizing.
- Scleritis is most commonly associated with Rheumatoid arthritis.
- The cause of scleritis is Collagen vascular disease.
- Complications of necrotising scleritis include sclerosing keratitis, keratolysis, complicated cataract, Uveitis & seconday glaucoma.
- Scleritis may cause retinal detachment & macular edema.
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