Scleritis is most commonly associated with: March 2005

Scleritis is most commonly associated
March 2005
a) Diabetes
b) Osteoarthritis
c) Rheumatoid arthritis
d) Hypertension
Correct Answer - C
Ans. C: Rheumatoid arthritis
Scleritis is a severe, destructive, chronic, painful, and potentially
blinding inflammatory disease of the Conjunctiva, Sclera and
Episclera tissues.
Symptoms includes redness and severe eye pain, which may radiate
to adjacent areas, the forehead, cheek, or behind the eye. This is
usually associated with light sensitivity, teary, and in some cases,
reduced or poor vision. The affected eye often has a bluish hue or
becomes an intense purple.
There are several different sub-types of Scleritis
Nodular Scleritis is characterized by a focal area of inflammation,
immovable, and tender, inflamed nodules on the eye.
Diffuse Scleritis
Diffuse Anterior Scleritis is the most common type, and is
characterized by widespread inflammation of the Anterior portion of
the Sclera, the white of the eye. The Diffuse type of Scleritis is,
fortunately, the most benign form of Scleritis and the most
responsive to therapy.
Necrotizing Scleritis is likely the worst form of the disease,
sometimes leading to loss of the eye from multiple complications,
severe pain, or occasionally perforation of the globe. It is often
associated with severe systemic disease and involvement of multiple
organs. An associated type of vascular inflammation, called
Vasculitis, may threaten the lives of those patients afflicted. Pain
with this condition is usually extreme, and damage to the Sclera is
often marked. Necrotizing scleritis also known as Scleromalacia
perforans is characterized by severe thinning of the Sclera of the
Eye, allowing for local outpouchings of the underlying dark Uveal
tissue. There are large abnormal blood vessels crossing areas of
Scleral loss. The condition occurs in an otherwise white and “quiet”
Eye, without pain. This type of Scleritis is associated with severe
Rheumatoid Arthritis, occasionally seen in Wegener’s
Granulomatosis and Relapsing Polychondritis.
Posterior Scleritis is quite rare, but usually presents with poor or
double vision, severe pain, proptosis (forward displacement of the
eye), Uveitis (inflammation inside the Uvea Tract), and limitation of
eye movement. An exudative Retinal detachment (fluid under the
Retina) may cause severe visual loss, Angle-Closure Glaucoma
from Choroidal effusion.
About 50% of Scleritis patients are associated with systemic
autoimmune disorders including rheumatoid arthritis, gout, wegener
granulomatosis, Relapsing Polychondritis, Systemic Lupus
Erythematosus, Polyarteritis Nodosa, Ankylosing Spondylitis, with
infections, or chemical or physical injuries.
It occurs most often in people between the ages of 30 and 60 (it is
rare in children). Scleritis may be the initial or only presenting clinical
manifestation of these potentially lethal disorders