Have you ever noticed that your eye suddenly turns red and feels like someone is poking you with a pair of pliers? Sometimes the pain is so bad that it wakes you up at night. Do you even find it difficult to look at the light? Yes, if you have these symptoms, it could be a condition called scleritis, which we are going to talk about today. Don't worry, we will talk about this in detail.
Simply put, what is scleritis?
Okay, let's first look at what Scleritis is. When you look at your eye, there is a part of the eye that looks white, which is what we call the sclera . Strictly speaking, this sclera is a strong protective covering around the eye. So, if there is some inflammation, that is, swelling and redness in this part called the sclera, that is what we call scleritis. In this case, not only does the eye become red, but it can also be very painful . Sometimes the pain increases even when the eye is moved back and forth. The most important thing is that if this condition is not treated properly, it can cause permanent damage to the eye and even loss of vision . Therefore, it is not a good idea to just ignore it because the eye is red.
What are the main types of scleritis?
Now, there are two main types of scleritis. One is anterior scleritis , which occurs in the front part of the sclera. The other is posterior scleritis , which occurs in the back part of the sclera. Both of these types are again divided in different ways.
Anterior Scleritis
This is the most common type. It is also divided into three parts:
- Diffuse scleritis: In this, inflammation may spread throughout the entire sclera. This is the most common subtype.
- Nodular scleritis: In this, a small lump (nodule) forms in one place on the sclera. The lump can sometimes be seen with our eyes.
- Necrotizing scleritis: This is the most dangerous type. It destroys the eye tissue and can sometimes lead to the loss of the entire eye . There is another dangerous subtype of this called scleromalacia perforans . It may be painless, but perforations can occur in the eye. This type occurs in about 4% of people who develop scleritis.
Posterior Scleritis
Because it occurs at the back of the sclera, symptoms can sometimes vary. There may be pain coming from inside the eye, blurred vision, etc. This type accounts for about 10% of all scleritis patients.
Who is most likely to develop scleritis?
Scleritis is most common in people between the ages of 47 and 60. However, it can occur in people younger or older than that. Women are more likely to develop it than men . One reason for this is that scleritis is associated with certain autoimmune conditions . However, scleritis caused by infections is more common in men.
How common is this situation?
In a country like America, it is said that about 10,500 new cases of scleritis are diagnosed each year. That is between four and six per hundred thousand. This condition is also seen in Sri Lanka, but it is difficult to give exact statistics.
What are the symptoms of scleritis?
Let's now see what symptoms may occur when scleritis develops.
- Redness and swelling of the white part of your eye (sclera) .
- A sharp pain in the eye and a feeling of soreness when touched . This pain can be so severe that it can wake you up at night. Sometimes this pain can spread to other parts of the face.
- Watery eyes (tears) .
- Difficulty looking at light (photophobia) .
If you have one or more of these symptoms, you should see an eye doctor immediately , because this is not a good situation to play with.
What causes scleritis?
Sometimes, no specific cause can be found for scleritis. Doctors call this 'idiopathic'. But more often, scleritis can develop if you have another medical condition, especially an autoimmune illness . Some of the diseases that are associated with this include:
- Rheumatoid arthritis: This is a disease that affects the joints on both sides of your body. It is the immune system disease most commonly associated with scleritis.
- Connective tissue diseases , such as systemic lupus erythematosus . Lupus and the chronic inflammation it causes can affect many parts of the body, including the joints, skin, lungs, brain, kidneys, and heart.
- Inflammatory bowel disease (IBD): This refers to a group of diseases that cause chronic inflammation in your intestines.
- Sjögren's syndrome: This autoimmune disease limits the secretion of moisture from the glands in your eyes and mouth.
- Scleroderma: In this disease, normal tissue is replaced by thick, hard fibrous tissue.
- Granulomatosis with polyangiitis: This disease is caused by inflammation of your tissues (granulomatous inflammation) and blood vessels (vasculitis). This can damage organ systems in the body.
In addition, scleritis can also be associated with:
- Infections: Scleritis can also be caused by certain infections. These can be bacterial , fungal, or viral . Fungal infections usually take longer to heal and have less severe outcomes than bacterial or viral infections. Scleritis can also be caused by Lyme disease .
- Trauma or injury to your eye, including surgery: These types of injuries can also often cause scleritis. An example is a condition called surgically induced necrotizing scleritis (SINS), which occurs after surgery .
- Medications used to treat or prevent bone diseases: These types of medications, for example bisphosphonates , are known to cause inflammatory reactions in the eye.
How do doctors diagnose scleritis?
When you see a doctor, he or she will do an eye exam and possibly a slit lamp exam to determine if this is scleritis.
If you have posterior scleritis, your doctor may order a CT scan (computed tomography - CT scan) or an ultrasound . If your scleritis is caused by an infection, your doctor may take a sample of something, such as pus, from your eye and send it to a lab for testing. Very rarely, your doctor may also order a biopsy .
What are the treatments for scleritis?
If you have very mild scleritis, your doctor may recommend using nonsteroidal anti-inflammatory drugs (NSAIDs) . However, in most cases, your doctor will prescribe a systemic corticosteroid, such as prednisone, for a longer period of time (seven to ten days).
Important: Never use these medications without medical advice. They can cause side effects.
If you have a recurrence of the inflammation, you may need intravenous corticosteroids .
If you have scleritis caused by an infection, you will need antibiotics , antifungals , or antiviral medications.
In severe cases like necrotizing scleritis, your doctor may work with a rheumatologist to prescribe immunotherapeutic drugs such as cyclophosphamide , methotrexate , and mycophenolate mofetil , or biologic agents such as rituximab and adalimumab .
Other treatments, such as scleral patching or grafts, may also be used, as may other types of tissue transplants.
What should we expect in this case of scleritis?
Scleritis is a treatable and treatable condition. If left untreated, scleritis can lead to vision loss . Posterior necrotizing scleritis is the most serious. Your doctor will also work with you to treat any other autoimmune conditions you may have.
How can you reduce the risk of developing scleritis?
In most cases, scleritis cannot be prevented. But you can take good care of your eyes .
- Wearing the necessary eye protection while you work or play certain contact sports can reduce the risk of damage to your eyes.
- If you have to touch your eyes, always keeping your hands clean can help reduce the risk of eye infections. Also, if you wear contact lenses, don't forget to clean them properly.
When should you see a doctor?
You should see a doctor anytime you have pain, redness, or swelling in one or both of your eyes. This is especially important if you have a weakened immune system or a medical condition . It's best to start treatment as soon as possible.
What is the difference between scleritis and other eye diseases?
This is where many people get confused. Let's look at the main differences.
Difference between Scleritis and Episcleritis
Scleritis is an inflammation of your sclera. Episcleritis is an inflammation of your episclera, the outermost layer of the sclera. Episcleritis usually heals on its own and is not as painful as scleritis.
Difference between Scleritis and Uveitis
The uvea is the layer under the sclera (the white part of the eye). Inflammation of your uvea is called uveitis . Both your uvea and sclera can be inflamed at the same time, but they are two different parts of your eye.
Difference between Scleritis and Conjunctivitis
Scleritis is an infection of the sclera. Conjunctivitis , which is what we call an 'eye infection,' is an infection of your conjunctiva. Your conjunctiva is the membrane that lines the sclera and the inside of your eyeball. Both conditions can cause your eyes to become red. However, conjunctivitis is not as serious as scleritis, and it is not as painful as scleritis .
The take-home message from this article
So, your eyes are very precious to you. Therefore, it is your responsibility to keep them healthy. If your eyes are red and painful, see an ophthalmologist or a general practitioner immediately . It is very important to find out quickly whether it is a condition like scleritis or something else. The best thing to do is to recognize and start treatment for any medical condition early, whether it is something that affects the eyes or something else in the body.
` Scleritis, white part of the eye, sclera, eye redness, eye pain, eye swelling, autoimmune disease, Scleritis, eye inflammation
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