How Your Ophthalmologist Can Help with Scleritis
Prompt treatment is the key to treating scleritis, an inflammatory disorder that affects the white surfaces of your eyes. Your ophthalmologist offers several treatments that can reduce inflammation and protect your eyesight.
What Is Scleritis?
Scleritis occurs when the sclera in one or both eyes becomes inflamed. The white connective tissue covers the exterior of your eyeball from front to back. It helps the eyeball keep its shape and offers protection against eye injuries.
Sclerititis in the front of the eye is called anterior scleritis, while posterior scleritis affects the back of the eye. Necrotizing scleritis, the most severe form of the disorder, can destroy the sclera and penetrate the eye, causing permanent vision loss. Anterior scleritis is the most common form of the disorder and may cause symptoms over the entire sclera or just one area.
Symptoms of scleritis include:
- Pain. Pain may range from mild to severe, depending on the type and severity of the inflammation. The pain may extend to your face and head and prevent you from sleeping. Pain in your eye should never be ignored. If your eye hurts, let your ophthalmologist know as soon as possible.
- Bumps. Small painful nodules (bumps) on the sclera may be present.
- Swelling. The white part of your eye may become swollen due to the disorder.
- Tearing. Your eyes may water more than usual.
- Vision Changes. Scleritis could affect your vision, causing blurry vision or loss of vision.
- Sensitivity to Light. You may notice that your eyes are more sensitive to sunlight and artificial light.
If you have anterior scleritis, the white part of your eye may turn red. Posterior scleritis doesn't usually cause a change in the appearance of the front of the eye.
What Causes Scleritis?
You may be more likely to develop scleritis due to:
- A Bacterial, Fungal or Parasitic Eye Infection
- An Eye Injury
- Lupus, Inflammatory Bowel Disease, Rheumatoid Arthritis, Sjogren's Syndrome, Scleroderma or Another Autoimmune Disorder
- Eye Surgery
- Side Effects from Some Medications Like Bisphosphonates (Drugs Used to Treat Osteoporosis)
According to StatPearls, 4 to 10 percent of scleritis cases are caused by infections, while 50 percent of all cases occur in people with autoimmune disorders. In some cases, scleritis may be the first sign that you have an autoimmune disorder. Middle-aged people and women are more likely to develop scleritis.
What Are the Treatments for Scleritis?
As scleritis can cause permanent loss of vision, the sooner you see your ophthalmologist and start treatment, the better. During your visit, your eye doctor will use a slit-lamp to examine your eyes after your pupils have been dilated with special drops. The slit-lamp is a lighted microscope that helps your ophthalmologist examine every part of your eye. If your eye doctor suspects posterior scleritis, he or she may recommend an ultrasound or computerized tomography (CT) scan to confirm or rule out the diagnosis. Depending on your symptoms, other tests may also be needed.
Reducing inflammation, relieving pain, and protecting your vision is the goal of scleritis treatment. As the inflammation decreases, you may notice that your vision no longer looks blurry or cloudy. If your symptoms are mild, your eye doctor may prescribe non-steroidal anti-inflammatory drugs (NSAIDS) and corticosteroid eye drops. If this treatment doesn't help, you may receive a prescription for oral corticosteroids. Corticosteroids are strong prescription medications that work quickly to reduce inflammation.
Immunosuppressive drugs or biologics may be helpful if your symptoms are severe or you aren't improving with other treatments.
If you have an autoimmune disorder, your ophthalmologist will coordinate your care with the doctor who treats your disorder. Keeping your autoimmune disorder under control could help you avoid scleritis in the future.
Are you worried that you may have scleritis? Call our office immediately to schedule an appointment.
Sources:
NCBI: StatPearls: Scleritis, 6/26/2023
https://www.ncbi.nlm.nih.gov/books/NBK499944/
American Academy of Ophthalmology: What Is Scleritis?, 9/9/2022
https://www.aao.org/eye-health/diseases/what-is-scleritis
Merck Manual: Scleritis, 4/2023
https://www.merckmanuals.com/professional/eye-disorders/conjunctival-and-scleral-disorders/scleritis
All About Vision: Scleritis, 2/24/2021