Tag: Scleritis

Scleritis

SCLERITIS

Q. 1

The cause of scleritis is –

 A

Collagen vascular disease

 B

TB

 C

Trauma

 D

Glaucoma

Q. 1

The cause of scleritis is –

 A

Collagen vascular disease

 B

TB

 C

Trauma

 D

Glaucoma

Ans. A

Explanation:

Ans. is ‘a’ i.e., Collagen vascular disease

o Scleritis is commonly associated with connective tissue disease (including collegen vascular disease) such as -4 RA, SLE, PAN, Wegener’s granulomatosis, Relapsing polychondritis.


Q. 2

All of the following are features of episcleritis except:

 A

Redness

 B

Marked pain

 C

Photophobia

 D

Lacrimation

Q. 2

All of the following are features of episcleritis except:

 A

Redness

 B

Marked pain

 C

Photophobia

 D

Lacrimation

Ans. B

Explanation:

Ans. Marked pain


Q. 3

The most common variety of scleritis is:

 A

Non-necrotizing anterior diffuse

 B

Non-necrotizing anterior nodular

 C

Anterior necrotizing with inflammation

 D

Anterior necrotizing without inflammation

Q. 3

The most common variety of scleritis is:

 A

Non-necrotizing anterior diffuse

 B

Non-necrotizing anterior nodular

 C

Anterior necrotizing with inflammation

 D

Anterior necrotizing without inflammation

Ans. A

Explanation:

Ans. Non-necrotizing anterior diffuse

Quiz In Between


Q. 4

Episcleritis periodica refers to:

 A

Fleeting type of episclerities

 B

Complicated episclertis

 C

Intermediate stage between episcleritis and scleritis

 D

None of the above

Q. 4

Episcleritis periodica refers to:

 A

Fleeting type of episclerities

 B

Complicated episclertis

 C

Intermediate stage between episcleritis and scleritis

 D

None of the above

Ans. A

Explanation:

Ans. Fleeting type of episclerities


Q. 5

Scleritis is associated with some systemic disease including connective tissue disorder in:

 A

35% of cases

 B

50% of cases

 C

66% of cases

 D

85% of cases

Q. 5

Scleritis is associated with some systemic disease including connective tissue disorder in:

 A

35% of cases

 B

50% of cases

 C

66% of cases

 D

85% of cases

Ans. B

Explanation:

Ans. 50% of cases


Q. 6

Episcleritis is commonly associated with:

March 2012

 A

Trachoma

 B

Rheumatoid arthritis

 C

Cataract extraction surgery

 D

Usually associated with none

Q. 6

Episcleritis is commonly associated with:

March 2012

 A

Trachoma

 B

Rheumatoid arthritis

 C

Cataract extraction surgery

 D

Usually associated with none

Ans. B

Explanation:

Ans: B i.e. Rheumatoid arthritis

Scleritis & associations

  • A history of rheumatoid arthritis is commonly obtained in patients with episcleritis
  • Cataract extraction surgeries may be associated with scleritis
  • Posterior scleritis is usually not associated with any systemic disease

Quiz In Between


Q. 7

Ciliary staphyloma is a complication of:

September 2012

 A

Scleritis

 B

Episcleritis

 C

Perforated corneal ulcer

 D

Degenerative myopia

Q. 7

Ciliary staphyloma is a complication of:

September 2012

 A

Scleritis

 B

Episcleritis

 C

Perforated corneal ulcer

 D

Degenerative myopia

Ans. A

Explanation:

Ans. A i.e. Scleritis


Q. 8

Scleritis is most commonly associated with:

March 2005

 A

Diabetes

 B

Osteoarthritis

 C

Rheumatoid arthritis

 D

Hypertension

Q. 8

Scleritis is most commonly associated with:

March 2005

 A

Diabetes

 B

Osteoarthritis

 C

Rheumatoid arthritis

 D

Hypertension

Ans. C

Explanation:

Ans. C: Rheumatoid arthritis

Scleritis is a severe, destructive, chronic, painful, and potentially blinding inflammatory disease of the Conjunctiva, Sclera and Episclera tissues.

Symptoms includes redness and severe eye pain, which may radiate to adjacent areas, the forehead, cheek, or behind the eye. This is usually associated with light sensitivity, teary, and in some cases, reduced or poor vision. The affected eye often has a bluish hue or becomes an intense purple.

There are several different sub-types of Scleritis

  • Nodular Scleritis is characterized by a focal area of inflammation, immovable, and tender, inflamed nodules on the eye.
  • Diffuse Scleritis
  • Diffuse Anterior Scleritis is the most common type, and is characterized by widespread inflammation of the Anterior portion of the Sclera, the white of the eye. The Diffuse type of Scleritis is, fortunately, the most benign form of Scleritis and the most responsive to therapy.
  • Necrotizing Scleritis is likely the worst form of the disease, sometimes leading to loss of the eye from multiple complications, severe pain, or occasionally perforation of the globe. It is often associated with severe systemic disease and involvement of multiple organs. An associated type of vascular inflammation, called Vasculitis, may threaten the lives of those patients afflicted. Pain with this condition is usually extreme, and damage to the Sclera is often marked. Necrotizing scleritis also known as Scleromalacia perforans is characterized by severe thinning of the Sclera of the Eye, allowing for local outpouchings of the underlying dark Uveal tissue. There are large abnormal blood vessels crossing areas of Scleral loss. The condition occurs in an otherwise white and “quiet” Eye, without pain. This type of Scleritis is associated with severe Rheumatoid Arthritis, occasionally seen in Wegener’s Granulomatosis and Relapsing Polychondritis.
  • Posterior Scleritis is quite rare, but usually presents with poor or double vision, severe pain, proptosis (forward displacement of the eye), Uveitis (inflammation inside the Uvea Tract), and limitation of eye movement. An exudative Retinal detachment (fluid under the Retina) may cause severe visual loss, Angle-Closure Glaucoma from Choroidal effusion.
  • About 50% of Scleritis patients are associated with systemic autoimmune disorders including rheumatoid arthritis, gout, wegener granulomatosis, Relapsing Polychondritis, Systemic Lupus Erythematosus, Polyarteritis Nodosa, Ankylosing Spondylitis, with infections, or chemical or physical injuries.
  • It occurs most often in people between the ages of 30 and 60 (it is rare in children). Scleritis may be the initial or only presenting clinical manifestation of these potentially lethal disorders.

Q. 9

Most common type of scleritis

 A

Non-necrotizing

 B

Necrotizing

 C

Posterior

 D

None

Q. 9

Most common type of scleritis

 A

Non-necrotizing

 B

Necrotizing

 C

Posterior

 D

None

Ans. A

Explanation:

Ans. is ‘a’ i.e., Non-necrotizing

Classification of scleritis

  • It can be classified as follows : 

I. Anterior scleritis (98%)

1. Non-necrotizing scleritis (85%)

  1. Diffuse
  2. Nodular

2.Necrotizing scleritis (13%)

  1. With inflammation
  2. Without inflammation (scleromalacia perforans) H) Posterior scleritis (2%)

Quiz In Between



Scleritis

SCLERITIS


SCLERITIS

  • 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.
CLASSIFICATION
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.

CLINICAL FEATURES

  • 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

  • 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.

Exam Important

  • 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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