Overview

• Transmural inflammation of the sclera
• F>M, mean age 40-60 years old
• In up to 60% of patients, associated with underlying systemic disorder or infection → most commonly rheumatoid arthritis, but also SLE, IBD and gout

Making Diagnosis

Clinical Features:

• Deep, aching, boring eye pain → exacerbated by eye movement and palpation, may radiate to rest of face
• Red Eye
• Photophobia
• Lacrimation

<aside> 💡 Episcleritis (inflammation more superficial) → painless red eye

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Investigations:

• Phenylephrine Drops → distinguish between scleritis and episcleritis. If eye redness improves after phenylephrine a diagnosis of episcleritis can be made.
• Ultrasound → detect signs of posterior scleritis
• Orbital CT/MRI → differentiate between orbital lesions
• Workup for Systemic Disease → eg. RA, ANA