Anterior scleritis: three case reports and a review of the literature.
BACKGROUND
Scleritis is a rare ocular condition involving vasculitis. It can result in severe ocular morbidity and has a high association with underlying systemic disease and mortality. Management can be challenging and under-diagnosis is a concern. Treatment usually requires systemic medications and co-management with a medical specialist in the appropriate field to manage any underlying systemic etiology.


METHODS
Three cases are presented: idiopathic nodular scleritis with complete recovery; bilateral, diffuse anterior scleritis with rheumatoid arthritis; and scleromalacia perforans treated with chemotherapeutic agents and co-managed with a rheumatologist. A search of the English language literature is reported, also.


RESULTS
The reported cases exemplify much of our knowledge regarding scleritis. The literature review focuses on the challenges of an accurate diagnosis and management. Management is challenging and, although standards exist, controversy remains. The literature discusses the relationship of scleritis to underlying systemic disease and the significant implication of this association.


CONCLUSIONS
Knowledge of scleritis may aid in determining a timely and accurate diagnosis and treatment of both the ocular and any underlying systemic conditions, thus decreasing morbidity and mortality.
Illinois Eye Institute and the Illinois College of Optometry, Chicago, Illinois 60616, USA. dcastell@eyecare.ico.edu
David D
DD
Castells
D000328:Adult; D000869:Anterior Eye Segment; D001172:Arthritis, Rheumatoid / Q000150:complications / Q000175:diagnosis / Q000209:etiology; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D015423:Scleritis / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy
D005938:Glucocorticoids