Scleritis
Focal or diffuse inflammation of sclera Isolated to eye or associated with systemic autoimmune condition such as rheumatoid arthritis or granulomatous polyangiitis (formerly Wegener granulomatosis) May lead to perforation of sclera and loss of eye
Episcleritis, anterior uveitis, conjunctivitis, BUT... Episcleritis causes relatively little pain and no scleral thinning Anterior uveitis causes diffuse or ciliary engorgement of conjunctival vessels, less pain, and no scleral thinningConjunctivitis causes diffuse engorgement of conjunctival vessels, no pain, and much more discharge
Refer urgently to ophthalmologist
Diagnosis includes search for underlying systemic condition Treatment involves systemic corticosteroids or other immune-modulating agents Threatened ocular perforation may require surgical patch grafts Outcome depends on type and aggressiveness of underlying condition and patient tolerance of medication used to treat
