Scleritis Treatment in Delhi, India

Scleritis is a serious inflammatory eye disease that affects the sclera, the white outer coating of the eye. If not addressed in a timely manner, it may result in significant discomfort and potentially lead to a loss of vision. Scleritis is usually associated with underlying autoimmune diseases, such as rheumatoid arthritis or lupus, and can be categorised based on its location and severity.

Types of Scleritis

Scleritis can be classified into several types based on the location and extent of inflammation:

Anterior Scleritis: The most common type affecting the front part of the sclera. It can be further divided into:

• Diffuse Scleritis: Widespread inflammation across the sclera.
• Nodular Scleritis: Characterised by nodules or lumps on the sclera.

Posterior Scleritis: A rare form that affects the back part of the sclera and can be more challenging to diagnose.

Symptoms of Scleritis

Scleritis typically presents with a range of symptoms that can vary depending on the type:

• Severe eye pain: Often described as deep, boring pain that may worsen with eye movement.
• Redness: A hallmark sign, usually covering a large portion of the white of the eye.
• Blurred vision: Caused by inflammation affecting the clarity of vision.
• Sensitivity to light (photophobia): A common symptom due to the inflamed sclera.
• Tearing: Excessive tearing can occur due to irritation.

Causes of Scleritis

Scleritis can be caused by various factors, with autoimmune diseases being the most common. These include:

• Autoimmune disorders: Conditions like rheumatoid arthritis, lupus, and ankylosing spondylitis are often linked to scleritis.
• Infectious causes: Though less common, infections caused by bacteria, viruses, or fungi can lead to scleritis. Fungal scleritis, for example, can occur following trauma or surgery.
• Trauma: Physical injury to the eye can trigger inflammation, leading to scleritis.

How is Scleritis Diagnosed?

Diagnosing scleritis involves a thorough eye examination by an ophthalmologist. The following methods are typically used:

• Clinical examination: A detailed assessment of the eye's appearance and the patient's symptoms.
• Imaging tests: Ultrasound or CT scans may be required to assess the extent of inflammation, particularly in posterior scleritis.
• Blood tests: To identify underlying autoimmune conditions or infections.

How is Scleritis Treated?

The treatment of scleritis focuses on reducing inflammation, alleviating pain, and addressing the underlying cause:

• Corticosteroids: Oral or topical steroids are commonly prescribed to reduce inflammation.
• Immunosuppressive medications: Drugs that suppress the immune system may be necessary for patients with autoimmune-related scleritis.
• Antibiotics or antifungals: If an infection causes scleritis, appropriate antimicrobial therapy is required.
• Surgery: In severe cases, surgical intervention may be needed to repair damage caused by the inflammation.

Risk Factors for Scleritis

Several risk factors increase the likelihood of developing scleritis:

• Autoimmune diseases: As mentioned, conditions like rheumatoid arthritis significantly raise the risk.
• Infections: Previous eye infections or systemic infections can predispose individuals to scleritis.
• Trauma: Any injury to the eye can potentially lead to scleritis.
• Age and gender: Middle-aged adults and women are more commonly affected.

Prevention of Scleritis

While it may not be possible to prevent all cases of scleritis, certain measures can reduce the risk:

• Manage underlying conditions: Controlling autoimmune diseases with appropriate medication and regular check-ups is crucial.
• Protect your eyes: Use protective eyewear to avoid trauma.
• Prompt treatment of eye infections: Seek immediate medical attention for any eye infection to prevent complications like scleritis.

When to Call the Doctor?

If you experience severe eye pain, significant redness, or sudden vision changes, you should seek immediate medical attention. Early diagnosis and treatment are essential to prevent potential complications.

Outlook

The prognosis for scleritis depends on the underlying cause and the timeliness of treatment. With appropriate management, the inflammation can be controlled, and vision can often be preserved. However, untreated scleritis can lead to complications such as vision loss, making early intervention critical.

Frequently Asked Questions

Can scleritis be cured completely?

While scleritis can be effectively treated, it may recur, especially if associated with an autoimmune condition. Long-term management is often necessary.

How long can scleritis last?

The duration of scleritis varies. Acute cases may resolve within weeks, while chronic scleritis can last for months or longer.

Is scleritis vision-threatening?

Yes, if not treated promptly, scleritis can lead to serious complications, including vision loss.

What viruses cause scleritis?

Viruses like herpes zoster and herpes simplex can cause scleritis, though viral causes are relatively rare.

Is scleritis itchy?

Scleritis is usually painful rather than itchy. Itchiness is more commonly associated with other eye conditions like conjunctivitis.

Can stress cause scleritis?

Stress is not a direct cause of scleritis, but it can exacerbate underlying autoimmune conditions, potentially triggering scleritis.

Review 

Reviewed By  Dr Smriti Goel- Consultant - Eye Surgery Eye Care / Ophthalmology on 16 Sept 2024.