Scleritis

Description, Causes and Risk Factors:

The sclera is an incomplete shell comprising approximately 90% of the outer coat of the eye; it begins at the limbus and terminates at the optic canal. The sclera is composed of extracellular matrix—collagen, elastin, proteoglycans, the bundles of which run in whorls and loops. The innermost part of the sclera is the lamina fusca, which has many grooves caused by the passage of ciliary vessels and nerves. Anteriorly, the sclera is continuous with the cornea at the corneoscleral junction, and lying just posterior to this, within the sclera, is the canal of Schlemm. Posterior to the canal is the scleral spur, which is triangular with its apex pointing anteriorly and inward and attaching to the ciliary body. The posterior pole of the sclera is weakened and has a sieve-like appearance (lamina cribrosa) where it is perforated by the axons of the optic nerve. Here, the sclera is fused with the dura mater and arachnoid sheaths of the optic nerve.scleritis

Scleritis is defined as inflammation of the sclera, and it has a characteristic clinical picture. It is typically a severe painful inflammatory process centered in the sclera that may involve the cornea, adjacent episclera, and underlying uvea; it poses a significant threat to vision.

Types may include:Anterior scleritis.
  • Anular scleritis.
  • Brawny scleritis.
  • Deep scleritis.
  • Gelatinous scleritis.
  • Malignant scleritis.
  • Necrotizing scleritis.
  • Nodular scleritis.
  • Posterior scleritis.
Scleritis occurs most often in people between the ages of 30 and 60 and is rare in children.

Inflammation of the sclera is usually associated with infections, chemical injuries, or autoimmune diseases such as rheumatoid arthritis and systemic lupus erythematosus. Sometimes the cause is unknown.

Infectious scleritis can be viral, bacterial, fungal, and parasitic. It is uncommon particularly in the absence of infectious keratitis. The mechanism of inflammation in many infections is thought to be partly or wholly immune mediated. Many organisms have been reported as possible causes of scleritis. Infections occur in tissue compromised by disease or trauma—both iatrogenic and accidental.

A common risk factor for infectious scleritis is a history of pterygium surgery with adjunctive mitomycin-C administration or beta irradiation.Other risk factors may include:Wegener's granulomatosis.
  • Systemic lupus erythematosus (SLE).
  • Polyarteritis nodosa.
  • Takayasu's arteritis

Patients with scleritis may present in one of two ways—they may already be known to have an underlying related disorder, such as rheumatoid arthritis, or the scleritis may present de novo in the absence of any known underlying systemic disease. The characteristic feature of scleritis is the severe pain that may involve the eye and orbit and radiates to involve the ear, scalp, face, and jaw. Scleritic pain is typically dull and boring in nature, exacerbated by eye movement, is worse at night often interfering with sleep, and characteristically wakens the patient from sleep early in the morning.

Symptoms:Eye pain that is severe.
  • Red patches on the normally white part of the eye.
  • Blurred vision.
  • Sensitivity to light - very painful.
  • Tearing of the eye.
  • Decreased visual acuity.
  • Photophobia.
Diagnosis:

Your eye doctor will ask you about your medical history and conduct a thorough examination.Scleritis is best detected by examining the sclera in daylight; retracting the lids helps determine the extent of involvement.Because of the association between scleritis and other general medical conditions, your doctor may suggest a comprehensive medical examination, including blood counts and other tests and evaluations.

Other aspects of the eye exam i.e. visual acuity testing, slit lamp examination, etc may be helpful. Ancillary tests CT scans, MRIs, and ultrasonographies may also be helpful.

Treatment:If scleritis is caused by an underlying disease, treatment of that disease may be necessary.
  • Corticosteroid eye drops help reduce the inflammation. Sometimes corticosteroids pills are taken by mouth. Newer, non-steroid anti-inflammatory (NSAID) drugs may be used in some cases.
  • If infection is the cause, your treatment will include antibiotics. In severe cases, surgery may be required to repair injured areas of the eyeball.
  • Patients with autoimmune diseases such as rheumatoid arthritis may need careful monitoring by an ophthalmologist with experience treating ocular inflammatory diseases.
NOTE: The above information is educational purpose. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition.Reference and Source are from:DISCLAIMER: This information should not substitute for seeking responsible, professional medical care.

0 Comments

Submit a Comment

Your email address will not be published. Required fields are marked *

This site uses Akismet to reduce spam. Learn how your comment data is processed.

Cart Preview

Regular Bedtime Linked to Better Heart Health and Metabolism

Regular Bedtime Linked to Better Heart Health and Metabolism

According to a recent study, completed by the scientists from the Duke University Medical Center in Durham, USA, regular bedtime is important for heart health and metabolism. A team of scientists examined the sleeping patterns of approximately 2,000 adults aged...

Regular Walking May Reduce Stroke Severity

Regular Walking May Reduce Stroke Severity

A new study, conducted by the scientists from the University of Gothenburg in Sweden, finds that light and moderate physical activity, for example walking and swimming, may help reduce the stroke severity. The study included approximately data from 1,000 individuals...

[WpProQuiz 1]

Featured Products

The 5 Best Accessories for Sports Fans

It is very entertaining to be a sport fan. There is a big variety of sport games that are extremely interesting to follow. Moreover, it is always fun to anticipate the score and watch the enthusiasm live. One of the benefits of being sports fan is using different...

read more

Exercise May Serve as an Antidepressant

A new study of nearly 18,000 participants found that those with high fitness at middle age were significantly less likely to die from heart disease in later life, even if they were diagnosed with depression. Doctor's Tips: How to Stay Fit While Treating Depression Dr....

read more

Fitness: Warm Ups Can Chill Out the Perfomance

The warm ups are supposed to increase body temperature and blood flow so the muscles and surrounding joints become more responsive and prepared for physical activity. Although there’s a neurological element to warm-ups, most research focuses on the physiological...

read more