Scleritis Follow-up

Updated: May 09, 2017
  • Author: Manolette R Roque, MD, MBA, FPAO; Chief Editor: Andrew A Dahl, MD, FACS  more...
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Follow-up

Further Outpatient Care

Patients should undergo a room-light scleral examination, a slit-lamp evaluation, and general eye examination at every follow-up visit.

Carefully monitor medication type, dose, and adverse effects. In case of therapeutic failure, change the medication type.

Consultation with a rheumatologist for associated systemic disease and/or immunomodulatory therapy follow-up care is recommended.

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Further Inpatient Care

In cases of pending scleral perforation, peripheral ulcerative keratitis perforation, or positive Seidel test, admit for scleral patch grafting.

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Inpatient & Outpatient Medications

Systemic medications include nonsteroidal anti-inflammatory drugs (NSAIDs), corticosteroids, or immunomodulatory agents, depending on the type of scleritis and/or associated disease.

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Complications

See the list below:

  • Keratopathy - Peripheral corneal thinning, acute stromal keratitis, sclerosing keratitis, interstitial keratitis, punctate keratopathy, or peripheral ulcerative keratitis

  • Uveitis - Anterior or posterior

  • Glaucoma

  • Cataract

  • Fundus abnormalities - Choroidal folds, subretinal mass, disk edema, macular edema, annular ciliochoroidal detachment, or serous retinal detachment

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Prognosis

Ocular prognosis of scleritis with systemic autoimmune diseases varies, depending on the specific autoimmune disease.

Scleritis in spondyloarthropathies or in systemic lupus erythematosus, usually a relatively benign and self-limiting condition, is diffuse scleritis or nodular scleritis without ocular complications.

Scleritis in granulomatosis with polyangiitis is a severe disease that can lead to permanent blindness; it is usually necrotizing scleritis with ocular complications.

Scleritis in rheumatoid arthritis or relapsing polychondritis is a disease of intermediate severity; it may be diffuse, nodular, or necrotizing scleritis with or without ocular complications.

Scleritis without systemic disease association is often more benign than scleritis accompanied by infection or autoimmune disease. These cases of idiopathic scleritis may be mild, shorter in duration, and more likely to respond to topical steroid drops alone.

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Patient Education

For excellent patient education resources, visit eMedicineHealth's Eye and Vision Center. Also, see eMedicineHealth's patient education article Eye Pain.

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