Scleritis
Scleritis is a deep, extremely painful inflammation and purple discoloration of the sclera that may severely damage vision.
Scleritis is most common among people in their 30s through 50s and affects women more often than men. In one third of cases, it affects both eyes. Scleritis may accompany rheumatoid arthritis, systemic lupus erythematosus, or another autoimmune disorder. About half of the cases of scleritis have no known cause.
Symptoms include pain in the eye (typically a deep, boring ache) that often interferes with sleep and reduces appetite. Other symptoms include eye tenderness, increased watering of the eye, and sensitivity to bright light. In some people, inflammation is severe enough to cause perforation of the eyeball and loss of the eye.
Doctors diagnose scleritis by its symptoms and appearance on slit lamp examination. Sometimes signs of scleritis can be seen on an ultrasound or computed tomography (CT) scan.
Doctors treat scleritis with nonsteroidal anti-inflammatory drugs (NSAIDs) or a corticosteroid, such as prednisone, which is given by mouth. Eye drops and ointments rarely help scleritis. If the person has rheumatoid arthritis or does not respond to corticosteroids, drugs that suppress the immune system, such as cyclophosphamide or azathioprine, may be needed.
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