Most Common Cause of Scleritis
Scleritis is an inflammation of the Sclera, the tough, outermost layer of the eye.
It is a rare but serious eye condition that can cause vision loss and severe eye pain.
The most common cause of Scleritis is an underlying autoimmune disorder or an infection, such as Herpes zoster.
Scleritis mainly affects mid-aged people (35-50 years). The condition is common in women (affecting 60-70% of patients).
If the condition is not treated promptly, it can cause severe vision loss or blindness.
Scleritis can affect both eyes and can range from mild to severe.
Symptoms include eye redness, pain, light sensitivity, and blurred vision.
Depending on the condition’s cause, other symptoms such as double vision, eye discharge, and dry eyes may also be present.
Cause of scleritis
The most prevalent cause of Scleritis is a persistent systemic disease.
It may be a crucial indicator of autoimmune disorders, infections, and injuries.
These may harm the delicate organ and have serious consequences.
Scleritis typically impacts both eyes when an underlying systemic illness is present.
Autoimmune disorders
Autoimmune disorders can cause Scleritis when the immune system mistakenly attacks the sclera. This could lead to inflammation.
Scleritis can sometimes be a symptom of an underlying autoimmune disorder. For example, Lupus, Rheumatoid arthritis, or Ankylosing spondylitis.
In other cases, Scleritis can be caused by a local infection or injury, such as an eye infection or trauma to the eye.
This inflammation can cause the sclera to become red, painful, and swollen.
Infection
Infection is one of the most common causes of Scleritis. Some common forms of infections that can cause Scleritis are as follows,
- Fungal infections – Aspergillosis
- Viral infections – Herpes simplex, Herpes zoster, or Adenovirus
- Bacterial infections – Staphylococcus, Streptococcus, or Pseudomonas
Infections can cause Scleritis in two ways.
At first, bacteria, viruses, or fungi directly invade the sclera, leading to inflammation and eye pain.
Secondly, an infection can cause an immune response that leads to inflammation of the sclera.
This type of Scleritis is often associated with underlying conditions, such as Lupus, Rheumatoid arthritis, or other autoimmune disorders.
It is essential to see an ophthalmologist if you experience any symptoms of scleritis.
Injury
Injury to the eye can cause Scleritis in two ways.
First, an injury to the eye can cause a direct inflammation of the sclera.
This can happen when a foreign object, such as dirt or dust, enters the eye and scratches the sclera.
Secondly, an injury to the eye can cause secondary Scleritis.
This is denoted as an inflammation of the sclera due to the body’s immune system responding to the injury.
Injury-induced scleritis can cause various symptoms, including redness, pain, and sensitivity to light. It can also cause vision loss if left untreated.
Symptoms
Some common symptoms of Scleritis are as follows,
- Dry eye
- Light sensitivity
- Corneal ulceration
- Inflammation of the sclera
- Blurred and decreased vision
- Tearing and excessive blinking
- Painful red eye and Burning sensation
- Swollen eyelids leading to crusting of the eyelids
Diagnosis
An Ophthalmologist usually diagnoses Scleritis through a comprehensive eye exam and tests to rule out other causes of the symptoms.
The eye doctor may perform a slit lamp exam using a magnifying lens to examine the eye and look for signs of inflammation.
To confirm the diagnosis, the doctor may also do a Fluorescein angiography.
This imaging test takes pictures of the blood vessels in the eye to look for signs of inflammation.
Other tests that may be used include a culture of the eye, a biopsy of the eye tissue, and an eye ultrasound.
Treatment of scleritis is based on the severity of the inflammation. It may involve using steroid eye drops like Lotepred Eye drop of 5 ml or injections, non-steroidal anti-inflammatory drugs, or immunosuppressant drugs.
Surgery may be necessary in some cases to treat severe scleritis.
When to see a doctor?
Scleritis may be a dangerous condition that needs to be promptly diagnosed and treated to avoid consequences.
It’s crucial to get medical attention from an ophthalmologist or other healthcare provider as soon as you encounter scleritis symptoms such as
- Redness
- Excruciating eye pain
- Changes in your vision
- Persistent redness in either one or both eyes
- Autoimmune conditions, infections, or exposure to irritants in the past
- Headaches, joint discomfort, or fatigue may accompany eye problems
- Intense eye pain that is not relieved by over-the-counter pain relievers
- Changes in eyesight, such as blurred vision or increased sensitivity to light
To diagnose scleritis and determine the underlying cause, your doctor will perform a comprehensive eye exam and tests.
This may include taking a detailed medical history, using a slit-lamp microscope to examine your eyes, and performing laboratory tests or imaging studies.
To prevent further flare-ups, your doctor may recommend lifestyle changes such as quitting smoking or avoiding irritants.
Summary
Scleritis is a severe and often painful inflammatory disorder affecting the sclera, the white outer layer of the eye.
The exact cause of Scleritis is unknown, but it is mainly considered an autoimmune disorder. However, other reasons might be possible.
Some factors that can increase the risk of developing scleritis include underlying autoimmune diseases such as Rheumatoid arthritis and Lupus.
Scleritis can cause significant eye pain, redness, and vision changes, so it is essential to seek medical attention if you experience these symptoms.
Always consult your doctor and make sure to adhere to the prescribed medications.
Frequently Asked Questions
Can high blood pressure cause eye Scleritis?
High Blood Pressure (Hypertension) is not a direct cause of Scleritis. Limited evidence suggests that high BP may be a risk factor for scleritis. It can increase the risk of other eye conditions, such as retinopathy, but it is not a direct cause of scleritis.
What Autoimmune disease causes Scleritis?
Scleritis is often associated with several autoimmune diseases. These include Systemic Lupus Erythematosus (SLE), Rheumatoid arthritis, and Granulomatosis with polyangiitis (GPA). GPA was previously known as Wegener’s Granulomatosis. In these conditions, the immune system attacks various tissues in the body. It includes the sclera of the eye, leading to inflammation and damage.
What are the infectious causes of Scleritis?
Infectious causes of scleritis are less common than autoimmune causes, but they can occur. Some contagious reasons for scleritis include Fungal infections, Lyme disease, Syphilis, Tuberculosis, and Herpes zoster. Infectious scleritis can be challenging to diagnose and treat. It is essential to seek medical attention if you experience symptoms of scleritis.
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