Scleritis - Arthritis & Scleritis Symptoms

Scleritis

The Yorkshire Eye Hospital

Scleritis is inflammation of the white part of the eye.

What is Scleritis?

The Sclera is the white part of the eye. When it becomes inflamed it is called Scleritis (Itis = inflammation). When only the outer part of the Sclera is inflamed it is called Episcleritis. This is a condition that often goes on its own without the need for treatment and does not disturb the vision. Patients with Scleritis are more commonly female and the greatest incidence is between the ages of 40-60 years.

What are the symptoms?

In 35-50% of cases Scleritis affects both eyes. The eye appears red and is painful. Sometimes the inflammation is only apparent at the back of the eye and this can reduce the vision in an eye that is not red - this is called Posterior Scleritis.

Scleritis is caused by an immune response to something such as an infection, trauma or a virus which then ‘cross-reacts' with the eye. While we want our immune system to fight infection we do not like the ‘side-effect' of this process which can cause conditions such as Scleritis and Arthritis (joint inflammation). It is surprising how many Rheumatological and eye conditions go together. Some of the patterns of this type of inflammation have recognised signs and symptoms, examples being Rheumatoid arthritis and Wegners Granulomatosis (blood vessel inflammation - see Vasculitis section). Because Scleritis therefore can be part of a more generalised inflammation disorder it is important that the problem is correctly identified.

How is it treated?

Getting to the correct diagnosis involves sending of blood, X-ray, Ultrasound and occasionally eye / brain scanning investigations. The treatment options depend on the severity of the Scleritis. If mild it can be controlled on eye drop or tablet Non-steroidal anti-inflammatory drugs (NSAIDS). If more aggressive then steroid tablets are needed (see Treatment with Steroids section). If the dose of steroid is too high for too long a period then steroid-sparing medication will be discussed.

Sometimes Scleritis can run a severe course despite medical treatment but usually the inflammation can be brought under control and the vision remains good.

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