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Scleritis: presentations, disease associations and management
  1. Joanne Sims
  1. Correspondence to Dr Joanne Sims, Department of Ophthalmology, Auckland District Health Board, Private Bag 92189, Auckland 1142, New Zealand or Auckland Eye, 8 St Marks Road, Remuera, Auckland 1020, New Zealand; JoSims{at}adhb.govt.nz

Abstract

Scleritis is a serious inflammatory condition that is often painful, and in severe cases can result in permanent loss of vision. Approximately half the patients affected have no identifiable cause, but 30%–40% have an underlying systemic autoimmune condition. Scleritis may be the initial manifestation of Wegener's granulomatosis or rheumatoid arthritis, and all patients with scleritis require a thorough systemic evaluation.

Scleritis has a variable presentation and disease course, and may be an acute monophasic illness, a relapsing remitting process, or take a chronic course. Treatment options include local therapy with subconjunctival steroid injections for non-necrotising scleritis, and systemic anti-inflammatory or immunosuppressive therapy. Biologic agents have been used with success in some refractory cases. Ocular and systemic morbidity is reduced by timely treatment with immunosuppressant medications.

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