Your sclera is, in simple terms, the white of your eye. It is the outermost layer of the eye and acts as a protective barrier. Scleritis is the inflammation of this white layer. Like with uveitis, scleritis is most often associated with underlying autoimmune or inflammatory diseases but can also be caused by infections or injury. Scleritis is often the first indication a patient has that he or she is suffering from an autoimmune or inflammatory disease. The most prominent symptoms of scleritis are eye redness and extreme pain.
If left untreated, the complications caused by the inflammation can lead to permanent vision loss, including blindness, so it is vital that patients seek medical help if they have symptoms. At Solomon Eye Physicians and Surgeons, we are proud to have Dr. Michelle Tarver as part of our team. Dr. Tarver is a board-certified ophthalmologist specializing in ocular inflammation and is highly skilled and knowledgeable in the treatment of scleritis caused by underlying immunological disorders. If you have pain and redness of the eye(s), schedule an exam at our Greenbelt or Bowie, MD office right away.
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Types of Scleritis
Scleritis can affect either the front (anterior scleritis) or back (posterior scleritis) of the sclera.
- Anterior scleritis is the most common and most easily treatable form.
- Nodular scleritis is a form of anterior scleritis and has accompanying bumps on the surface of the eye that are sore or that hurt if touched.
- Necrotizing scleritis is the most serious form of anterior scleritis and has the potential to kill scleral tissue.
- Posterior scleritis is the rarest form and can be difficult to detect due to a lack of obvious symptoms.
Symptoms of Scleritis
The most obvious and common symptoms of scleritis are extreme redness and eye pain. For some patients, the pain may even spread out to the rest of the face. However, the different types of scleritis can have varying symptoms, especially posterior scleritis. Aside from redness and pain, the symptoms of anterior scleritis can include:
- Worsening pain with eye movements
- Light sensitivity
- Blurred or decreased vision
- Significant eye-watering
The symptoms of posterior scleritis are less obvious, which often makes it more difficult to diagnose. Some of the symptoms can include:
- Pain only with eye movements
- Double vision
- Migraine-type headaches
Causes of Scleritis
Scleritis can be caused by infection, viruses, and trauma, as well as systemic autoimmune, inflammatory, and connective tissue disorders. Many cases, approximately half are associated with systemic disorders, including:
- Rheumatoid arthritis
- Sjogren's syndrome
- Wegener's disease
- Inflammatory bowel disease
To diagnose scleritis, Dr. Tarver will perform a thorough eye exam, review your medical history, and possibly take blood and/or tissue samples for lab testing. These samples will be tested to check for underlying conditions, as well as to rule out other types of eye inflammation, such as blepharitis and pink eye.
As part of the medical history review, she will need to have as much detail as possible on you and your family's history of any autoimmune, inflammatory, or connective tissue disorders because of how commonly they are associated with scleritis. If you do in fact have scleritis but no history of these kinds of conditions, Dr. Tarver will likely refer you to a rheumatologist for further testing. Many times, a diagnosis of scleritis is how a patient finds out they also have an underlying condition.
Treatment and Prognosis
Much like with uveitis, the treatment for scleritis depends on its cause and type. If Dr. Tarver discovers that your scleritis is caused by an untreated or poorly managed underlying autoimmune or inflammatory disease, the most important part of your treatment will be with a referred autoimmune specialist to get the condition under control. Dr. Tarver will work closely with this specialist to manage your ocular symptoms during this process in order to avoid or reduce any further damage to the eyes. Treatments, in this case, may include eye drop or oral forms of nonsteroidal anti-inflammatory drugs (NSAIDs), corticosteroids, or immunosuppressive drugs.
If your scleritis is caused by a bacterial or fungal infection, the treatments may include eye drop or oral forms of antibiotics and antifungal medication.
In severe cases of scleritis in which there is tissue damage, a scleral graft or other reparative surgery may be needed.
Whether the scleritis is caused by an infection or underlying systemic disease, it is always a serious condition with the potential to lead to the full loss of vision if not treated early enough. It is extremely important to seek medical treatment from a board-certified ophthalmologist specializing in ocular inflammation, like Dr. Tarver, at the very first sign of symptoms.
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See a Scleritis Specialist
Dr. Michelle Tarver has devoted her career to treating patients with ocular inflammation, such as scleritis. If you are experiencing abnormal eye pain and redness, we urge you to make an appointment with Dr. Tarver right away to receive a proper diagnosis and treatment plan. Scleritis is a very serious condition that can permanently affect your vision if not treated early on, but Dr. Tarver at Solomon Eye Physicians and Surgeons can help.