SCLERITIS

(TYPES, DIFFERENTIAL
DIAGNOSIS AND
MANAGEMENT)
Introduction
• Scleritis is a severe ocular
inflammatory condition affecting the
sclera, the outer covering of the eye.
It can be categorized as anterior with
diffuse, nodular, or necrotizing
subtypes and posterior with diffuse
or nodular subtypes based on
location.
Types
• Based on causes; Non- • Based on location
infectious Vs Infectious
• Anterior Scleritis- Occurs in 98% of
• Non- infectious - Autoimmune cases; Mild to moderate pain and
tenderness; worse at night.
disease, Trauma and surgery,
Drug-induced scleritis • Posterior Scleritis- Occurs in 2% of
cases, Can occur in conjunction with
(bisphosphonates) anterior scleritis.
• Infectious- viral, bacteria, fungal.
Divided into primary and
secondary infectious.
Sub-Types
• Anterior Scleritis-

• Non-necrotizing-(75% of all cases

of anterior scleritis).
• Diffuse
• Nodular

• Necrotizing- (15% of cases)

• with inflammation
• without inflammation
Symptoms and Signs
Symptoms • Signs

1. Severe pain • Edematous swollen sclera

2. Tenderness of globe • profound dilatation of the deep
3. Photophobia episcleral vascular plexus
4. Epiphora • concurrent corneal ulceration and
inflammation
5. Visual loss.
Differential Diagnosis and Management

Differential Diagnosis- Management

Episcleritis
Acute glaucoma NSAIDs (indomecthacin)
Anterior Uveitis Glucocorticoids
Allergic conjunctivitis Immunosuppressive medications
Masquerade Scleritis ((methotrexate, mycophenolate mofetil, azathioprine)
Tumor necrosis factor
inhibitors(infliximab and adalimumab)
Surgery (patch scleral graft)
Thank you