- Granulomatous inflammation of the sclera.
- May present in association with systemic diseases i.e. rheumatoid arthritis, SLE, polyarteritis nodosa, or Wegener's granulomatosis.
- Symptoms: ocular pain with or without decreased vision.
- May be self-limiting or progress to necotizing process that may be potentially blinding.
- May be classified into non-necrotizing or necrotizing anterior scleritis and non-necrotizing or necrotizing posterior scleritis.
- Non-necrotizing inflammation may be differentiated into nodular and diffuse scleritis.
- Complications: scleral thinning (especially in the chronic recurrent scleritis), scleromalacia, scleral perforation, sclerosing keratitis, peripheral corneal melting, uveitis, cataract, macula edema, retinal detachment and choroidal granuloma.
- Systemic rheumatology evaluation.
- Always rule out infection in cases of necrotizing scleritis.
- Treatment: systemic NSAIDs, systemic or topical corticosteroids, cyclophosphamide, cyclosporin or other immunosuppressive therapies.