Eye conditions & symptoms 4 min read

Understanding Scleritis

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Scleritis is a condition that causes the Sclera (the whites of the eyes) to become inflamed. The condition can also affect tissue deeper in the eye, learn more about the condition and possible treatments.

Types of Scleritis 

sign of scleritis

Scleritis can be broken down into the following different types:

  • Posterior Scleritis (occurring at the back of the eye)
  • Anterior Scleritis (occurring at the front of the eye)
    • Necrotising (Where body tissue dies)
      • With Inflammation
      • Without Inflammation (Scleromalacia Perforans) 
    • Non-Necrotising 
      • Diffuse Anterior Scleritis 
      • Nodular Anterior Scleritis 

Signs & Symptoms

Scleritis can present with the following symptoms: 

  • Eye redness.
  • Severe gouging pain in and around the eye. 
  • The sclera can become slightly blue or purple.
  • Blurred vision.
  • Watery eyes.
  • Photophobia.

Diffuse anterior non-necrotising scleritis can cause consistent redness to develop in the eye, while nodular anterior non-necrotising scleritis can result in the formation of tender bumps on the eye.

Necrotising anterior scleritis with inflammation is the most serious type of scleritis, and it can cause severe pain, tenderness around the eye, and often permanent eye damage. 

Necrotising anterior scleritis without inflammation only occurs in long-standing rheumatoid arthritis patients - it causes the sclera to thin gradually but does not present with soreness or redness.

Posterior scleritis is a rare form of the condition, and it can cause pain particularly when you move your eye. There may not be any redness but the condition can result in a loss of vision. 

Complications of Scleritis

Scleritis can result in the eye structure becoming permanently damaged, causing:

If any of these conditions occur, your vision may be permanently affected and you may require surgery.

What Causes Scleritis?

Scleritis is caused by inflammation, however the root cause of the inflammation is not yet known. The condition may be more likely to develop if you have another inflammatory condition, and can also be a result of a bacterial, fungal, or, viral infection.

Risk Factors

Scleritis is an uncommon condition that affects around 4 in 100,000 each year. You may be at a higher risk if you are aged forty to sixty, while scleritis is also found slightly more in women. If you have any underlying inflammatory conditions such as rheumatoid arthritis, it may also be more likely you will develop scleritis.

How is Scleritis Diagnosed? 

woman having an eye examination for photophobia

Scleritis is normally diagnosed during a slit-lamp examination at an eye hospital.  

How Do You Treat Scleritis? 

If you present with scleritis you will be referred to an ophthalmologist or other eye specialist, where they can determine the type of scleritis you have, how severe it is, and what treatment to prescribe.

You may be given steroid injections directly into the sclera or around the eye, and if these are ineffective then they may suggest immunosuppressants, which can take a number of weeks to work.

Non-necrotising types of scleritis can be treated with oral NSAID medication, or oral steroids if this doesn’t work, and necrotising types should be treated with immunosuppressants and oral steroids as soon as possible. 

Treatment isn’t effective for Scleromalacia Perforans, but research into the condition is ongoing.