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Scleritis

Matthew J. Schear, DO, MS and Anne S. Steiner, MD Reviewed 06/2018
 


BASICS

DESCRIPTION

  • Scleritis is a painful, inflammatory process of the sclera, part of the eye’s outer coat.

    • Categorized into anterior or posterior and diffuse, nodular, or necrotizing

    • Commonly associa...

DIAGNOSIS

HISTORY

  • Redness and inflammation of the sclera

    • Can be bilateral in about 40% of cases (1)[B]

  • Photophobia and tearing

  • Pain ranging from mild discomfort to extreme localized tenderness

    • May be d...

TREATMENT

GENERAL MEASURES

If scleral thinning, glasses/eye shield should be worn to prevent perforation. 

MEDICATION

  • First-line therapies for noninfectious scleritis (3)[C]

    • Oral NSAID therapy, choice b...

ONGOING CARE

FOLLOW UP RECOMMENDATIONS

Avoid contact lenses—wear only if there is corneal involvement, which is rare. 

Patient Monitoring

  • Patient in the active stage of inflammation should be followed ve...

REFERENCES

1
Sainz de la Maza M, Molina N, Gonzalez-Gonzalez LA, et al. Clinical characteristics of a large cohort of patients with scleritis and episcleritis. Ophthalmology.  2012;119(1):43–50. ...

ADDITIONAL READING

CODES

ICD10

  • H15.009 Unspecified scleritis, unspecified eye

  • H15.019 Anterior scleritis, unspecified eye

  • H15.039 Posterior scleritis, unspecified eye

  • H15.099 Other scleritis, unspecified eye

  • H15.059 Scleroma...

CLINICAL PEARLS

  • Episcleritis is a self-limited inflammation of the eye with mild discomfort. Scleritis is a painful, severe, and potentially vision-threatening condition. Both conditions can be associ...

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