A Complete Guide to Scleritis Treatment
Scleritis is a painful, severe, and blinding condition. It affects the cornea, episclera, and uveal tract.
Up to 50% of people with Scleritis have an underlying condition, generally a rheumatic disease.
Scleritis is treatable. The treatment includes reducing inflammation before it causes permanent damage.
Scleritis pain is also related to inflammation, so reducing swelling will reduce symptoms.
The treatment is done in a step-by-step fashion. Check with your doctor for the best Scleritis treatment.
As per your condition, they will recommend you suitable medicine. Read on to learn how to treat Scleritis.
Scleritis treatment
Scleritis needs to be treated as soon as you see the symptoms. If left untreated, it can also lead to vision loss.
Your eye doctor will help you determine the best course depending on the severity of your Scleritis and the inflammation level of your eye.
It may include prescription or over-the-counter medications for Scleritis.
For example, suppose you have anterior or posterior necrotizing Scleritis. In that case, you require more intensive therapy than people with just an anterior disease.
Surgery may be required in severe cases of Scleritis. The procedure entails repairing tissues in the sclera to improve muscle function and prevent vision loss.
Sclera treatment may also depend on addressing the underlying causes.
For example, if you have an autoimmune disorder, treating it will help you avoid recurring cases of Scleritis.
Medications for Scleritis
Here are some prescription and OTC medications used to treat this eye condition:
Nonsteroidal anti-inflammatory drugs (NSAIDs)
If you have mild to moderate Scleritis, your doctor might recommend NSAIDs as the first line of treatment.
As per Medscape, NSAIDs are generally effective in one-third of individuals with diffuse anterior Scleritis and two-thirds with nodular anterior Scleritis.
They also benefit people with idiopathic posterior Scleritis.
They can include selective and non-selective Cyclo-Oxygenase inhibitors (COX inhibitors).
Non-selective COX inhibitors such as Flurbiprofen, Indomethacin, and Ibuprofen may be used.
If your doctor recommends oral NSAIDs, remember that they can cause side effects such as gastric bleeding.
If you have kidney issues, inform your doctor, as they may cause renal toxicity.
Selective COX -2 inhibitors may have more cardiovascular side effects.
Nevanac eye drops are an NSAID used for treating pain and inflammation in the eyes.
Corticosteroids
Topical Corticosteroids can help reduce inflammation if NSAIDs have failed to provide relief.
In mild cases of Scleritis, topical steroids like Prednisolone acetate 1.0% can be used.
Eye drops such as Lotopred may help reduce inflammation and provide relief to your eyes.
Check with your doctor before taking any Corticosteroids, as they have a high failure rate.
Periorbital and subconjunctival steroid injections can also be recommended as adjunct therapy, even though more research is required on this subject.
Oral glucocorticoids are synthetic versions of Glucocorticoids, the naturally occurring steroids in your body.
They have various benefits. One of them is to stop inflammation by entering cells and suppressing the proteins that cause it.
Check with your doctor for the most effective Scleritis treatment.
Immunosuppressive and Immunomodulatory agents
If Corticosteroids are not showing any results, your doctor may add or substitute with Immunosuppressive medications.
Immunosuppressants are medicines that keep your immune system in check.
The body’s immune system helps fight off infections that cause illness. But sometimes, the immune system mistakenly attacks healthy cells and tissues.
Immunosuppressants can slow or stop this response.
Methotrexate is effective as a steroid-sparing agent for long-term inflammation control in noninfectious Scleritis.
Other medicines such as Azathioprine, Mycophenolate mofetil, Cyclophosphamide, or Cyclosporine may also be helpful.
Immunosuppressive drugs are supplemented with Corticosteroids in the first month for some cases of Necrotizing Scleritis.
The Corticosteroids can be tapered slowly.
IMT can help reduce the dependency on steroids.
It can help manage ocular inflammation or an underlying systemic disease.
A lot of people with Scleritis require IMT. One study showed that 38% of patients with Scleritis required escalation to IMT.
In another study, 25% of people with Scleritis needed IMT.
IMT includes biological response modifiers, such as Infliximab or Adalimumab, which may be effective in therapeutic failure.
Rituximab is effective in case reports, small case series, and randomized trials for noninfectious Scleritis.
Antibiotics
As per a study, most Scleritis cases are autoimmune. The treatment for such cases includes topical and systemic corticosteroids.
It is crucial to differentiate infectious scleritis from noninfectious scleritis.
Corticosteroids or immunosuppressive agents can cause negative interactions when ingested with antibiotics.
Infectious scleritis is less common. Occurring only in 5%–10% of cases and requiring directed antimicrobial therapy.
Treatment guidelines for infectious scleritis need to be better established.
Yet, Doctors recommend Initial treatment with intensive broad-spectrum antibiotics.
These antibiotics generally address the most common causative organisms.
Topical antibiotics can help treat Scleritis due to Staphylococcus and Streptococcus. Examples of such medicines are fortified Cefazolin and Fluoroquinolones
Antifungal medications can help in some cases of Sjogren’s syndrome.
Surgery
Surgery may also be necessary for severe cases of Scleritis.
The process includes the repair of tissues in the sclera. It improves muscle function and prevents vision loss.
Eye banks offer scleral grafts from either fresh donors or preserved sclera.
Grafts can be done before the effects of systemic immunosuppressants show up in cases where a perforation is about to happen.
Home treatment
Unfortunately, Scleritis is a severe medical condition. There are no home remedies available for treating this condition.
If you have mild scleritis, an OTC Ibuprofen may be enough to ease your eye pain and inflammation.
You can get these medicines from any online or offline pharmacy. Most of the time, corticosteroids can help treat the swelling.
However, it is important to check with your eye doctor.
Takeaway
Scleritis is a severe eye condition that has many causes. If left untreated, it can also lead to vision loss.
There are various medicines available that can be effective and help you.
NSAIDs, immunosuppressants, and Corticosteroids can help you reduce inflammation and provide relief.
There is a surgical option available as well for severe Scleritis treatment. Check with your ophthalmologist for the best Scleritis treatment.
Frequently asked questions
Can Scleritis be cured completely?
In most cases, the Scleritis goes away with treatment. But it may come back. Proper treatment can help you fight this condition and reduce the risk of vision loss.
What is the best treatment for Scleritis?
Various treatments are available for Scleritis, such as nonsteroidal anti-inflammatory drugs (NSAIDs), glucocorticoids, or other Immunosuppressive drugs. Check with your ophthalmologist for the best Scleritis treatment.
How long does it take for Scleritis to heal?
With treatment, Scleritis can sometimes go away in a few weeks. But it can last longer, even years. It is essential to receive the necessary follow-up treatment.
How can I treat Scleritis at home?
Unfortunately, Scleritis is a severe medical condition. There are no home remedies available for treating this condition. Consult a doctor for Scleritis treatment.
Can eye drop help Scleritis?
Nonsteroidal anti-inflammatory drugs (NSAIDs) and corticosteroid eye drops can help you reduce inflammation and provide relief. Check with your doctor, as Scleritis treatment depends on the severity and cause of the condition.
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