Related articles: Sclerite
Definition
Sclerite is an inflammation of the sclera, which is the fibrous membrane that covers most of the eyeball and is commonly called "white of the eye". The inflammatory process can involve only one quadrant (focal scleritis) or involve the entire eyeball (diffuse scleritis). Furthermore, inflammation can lead to the formation of an edematous, reddish-purple and detected nodule (nodular scleritis) or the formation of an avascular area (necrotizing sclerite, with or without inflammation). Necrotizing scleritis is more frequently associated with systemic diseases and serious eye complications, such as perforation of the eyeball.
Scleritis can be caused by infections (eg varicella / zoster), drugs (eg bisphosphonates) and chemicals. The causes, however, are not always identifiable (idiopathic form). Scleritis is also commonly associated with connective tissue diseases and systemic vasculitis.
Most common symptoms and signs *
- Ocular pain
- Edema
- Fotofobia
- Tearing
- Eyes reddened
- Reduced vision
- Double vision
- Blurred vision
Further indications
Symptoms include redness and eye pain, hyperlacrimation, photophobia, blurred or diminished vision. In severe cases, one may have diplopia.
In scleritis, the pain is moderate-intense, penetrating and irradiated (at the forehead, at the eyebrow and at the jaw); increases by moving the eyes and awakening the patient during the night.
Diagnosis is made clinically and by examination with a slit lamp, CT scan or ultrasound. If an infectious sclerite is suspected, smears or biopsies are used.
The therapy involves the use of topical and systemic corticosteroids (prednisone) and sometimes immunosuppressive drugs, such as cyclophosphamide or azathioprine.
