What is Scleritis? Understanding the Causes, Symptoms, and Treatment
- Posted
- Medically Reviewed by Mr Mfazo Hove Consultant Ophthalmologist
- Author: Chris Dunnington
- Published: February 26, 2025
At Blue Fin Vision® Eye Clinic on Harley Street, London, we often encounter patients with various eye conditions, including scleritis. This serious eye disorder can be both painful and potentially sight-threatening if left untreated. In this comprehensive guide, we’ll explore what scleritis is, its causes, symptoms, and the most effective treatments available.
Understanding Scleritis
Scleritis is an inflammatory condition that affects the sclera, the white outer layer of the eye. This tough, fibrous tissue helps maintain the eye’s shape and protects its internal structures. When inflammation occurs in the sclera, it can lead to severe pain, redness, and in some cases, vision loss.
Types of Scleritis
Scleritis can be classified into two main types:
- Anterior Scleritis: This is the more common form, affecting the front part of the eye. It can be further subdivided into:
- Diffuse scleritis
- Nodular scleritis
- Necrotizing scleritis (with or without inflammation)
- Posterior Scleritis: A rarer form that affects the back of the eye and can be more challenging to diagnose.
Scleritis Causes
Understanding what causes scleritis is crucial for effective treatment. While the exact cause isn’t always clear, scleritis is often associated with underlying autoimmune conditions. Some common scleritis causes include:
- Autoimmune diseases: Rheumatoid arthritis, lupus, and granulomatosis with polyangiitis are frequently linked to scleritis.
- Infections: In rare cases, bacterial or viral infections can lead to scleritis.
- Trauma: Eye injuries can sometimes trigger scleritis.
- Medication side effects: Certain medications may cause scleritis as a rare side effect.
It’s important to note that in some cases, the cause of scleritis remains unknown, which is referred to as idiopathic scleritis.
Recognising Scleritis Symptoms
Early recognition of scleritis symptoms is crucial for prompt treatment. The most common signs and symptoms of scleritis include:
- Severe eye pain: Often described as a deep, boring pain that may worsen at night or with eye movement.
- Redness: Unlike other eye conditions, the redness in scleritis is often a deep purple or bluish hue.
- Sensitivity to light (photophobia)
- Tearing
- Blurred vision
- Tenderness when touching the eye area
In cases of posterior scleritis, patients may also experience:
- Reduced vision
- Eye movement pain
- Proptosis (bulging of the eye)
If you experience any of these symptoms, it’s crucial to seek immediate medical attention from an eye specialist.
Diagnosing Scleritis
At Blue Fin Vision® Eye Clinic in London, our expert ophthalmologists use various methods to diagnose scleritis:
- Comprehensive eye examination: Using a slit lamp to examine the eye’s structures in detail.
- Ocular ultrasonography: Particularly useful for diagnosing posterior scleritis.
- Blood tests: To check for underlying autoimmune conditions.
- Imaging studies: Such as CT or MRI scans, may be necessary in some cases.
Early and accurate diagnosis is key to preventing complications and preserving vision.
Scleritis Treatment Options
The goal of scleritis treatment is to reduce inflammation, alleviate pain, and prevent vision loss. The treatment plan will depend on the severity of the condition and any underlying causes. At our Harley Street clinic, we offer a range of treatment options:
Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)
For mild cases of scleritis, oral NSAIDs may be the first line of treatment. These medications help reduce inflammation and alleviate pain.
Corticosteroids
In more severe cases or when NSAIDs are ineffective, corticosteroids may be prescribed. These can be administered:
- Orally
- Intravenously
- As topical eye drops (in some cases)
Immunosuppressive Drugs
For patients with severe scleritis or those associated with autoimmune diseases, immunosuppressive medications may be necessary. These can include:
- Methotrexate
- Mycophenolate mofetil
- Cyclophosphamide
Biologic Agents
In recent years, biologic agents have shown promise in treating severe or refractory scleritis. These medications, such as rituximab or adalimumab, target specific components of the immune system.
Treating Underlying Conditions
If scleritis is caused by an underlying autoimmune disease, treating that condition is crucial for managing scleritis effectively. This often involves collaboration between your ophthalmologist and rheumatologist.
Preventing Complications
Untreated or poorly managed scleritis can lead to serious complications, including:
- Corneal thinning or ulceration
- Glaucoma
- Cataracts
- Retinal detachment
- Vision loss
Regular follow-ups and adherence to the treatment plan are essential to prevent these complications.
Living with Scleritis
While scleritis can be a challenging condition, with proper management, most patients can maintain good eye health and vision. Here are some tips for living with scleritis:
- Follow your treatment plan diligently
- Attend regular check-ups with your ophthalmologist
- Protect your eyes from injury and excessive sunlight
- Maintain a healthy lifestyle to support your overall immune health
- Be aware of your symptoms and report any changes promptly
Why Choose Blue Fin Vision® for Scleritis Care?
At Blue Fin Vision® Eye Clinic on Harley Street, London, we offer:
- Expert diagnosis: Our experienced ophthalmologists use state-of-the-art technology for accurate diagnosis.
- Personalised treatment plans: We tailor our approach to each patient’s unique needs.
- Comprehensive care: We work closely with rheumatologists and other specialists to manage underlying conditions.
- Advanced treatments: Access to the latest therapies and treatment modalities.
- Ongoing support: Regular follow-ups and support to manage your condition effectively.
Conclusion
Scleritis is a serious eye condition that requires prompt and expert care. Understanding the causes, recognising the symptoms, and seeking timely treatment are crucial steps in managing this condition effectively. At Blue Fin Vision® Eye Clinic, we’re committed to providing the highest standard of care for patients with scleritis and other eye conditions.
If you’re experiencing symptoms of scleritis or have concerns about your eye health, don’t hesitate to contact our Harley Street clinic. Our team of expert ophthalmologists is here to provide the care and support you need to maintain healthy vision.
Remember, when it comes to your eye health, early intervention is key. Trust the experts at Blue Fin Vision® to provide comprehensive, compassionate care for all your eye health needs.
