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Scleritis

Scleritis is an inflammation of the sclera (the white outer wall of the eye).

Alternative Names

Inflammation - sclera

Causes

Inflammation of the sclera is often linked to autoimmune diseases such as rheumatoid arthritis and systemic lupus erythematosus . Sometimes the cause is unknown.

Scleritis occurs most often in people between the ages of 30 and 60. It is rare in children.

Symptoms

Symptoms of scleritis include:

A rare form of this disease causes no eye pain or redness.

Exams and Tests

Your health care provider will perform the following tests:

  • Eye exam
  • Physical exam and blood tests to look for conditions that may be causing the problem

It is important for your provider to determine if you have scleritis or a less severe form of inflammation, such as episcleritis.

Treatment

Treatments for scleritis may include:

  • Corticosteroid eye drops to help reduce the inflammation
  • Corticosteroid pills
  • Newer, nonsteroid anti-inflammatory (NSAID) drugs in some cases
  • Certain anti-cancer drugs (immune-suppressants) for severe cases

If scleritis is caused by an underlying disease, treatment of that disease may be needed.

Outlook (Prognosis)

In most cases, the condition goes away with treatment. But it may come back.

The disorder causing scleritis may be serious. However, it may not be discovered the first time you have the problem. The outcome will depend on the specific disorder.

Possible Complications

Complications may include:

  • Return of scleritis
  • Side effects of long-term corticosteroid therapy
  • Perforation of the eyeball, leading to vision loss if the condition is left untreated

When to Contact a Medical Professional

Call your health care provider or ophthalmologist if you have symptoms of scleritis.

Prevention

Most cases cannot be prevented.

People with autoimmune diseases, such as rheumatoid arthritis, may need to have regular check-ups with an ophthalmologist familiar with the condition.

References

Watson P. Diseases of the sclera and episclera. In: Tasman W, Jaeger EA, eds. Duane's Ophthalmology. 2013 ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2012:vol 4, chap 23.

Yanoff M, Cameron D. Diseases of the visual system. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine. 24th ed. Philadelphia, PA: Saunders Elsevier; 2011:chap 431.

Updated: 9/2/2014

Franklin W. Lusby, MD, ophthalmologist, Lusby Vision Institute, La Jolla, CA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.


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