title: Scleritis: presentations, disease associations and management.
abstract: Scleritis is a serious inflammatory condition that is often painful, and in severe cases can result in permanent loss of vision. Approximately half the patients affected have no identifiable cause, but 30%-40% have an underlying systemic autoimmune condition. Scleritis may be the initial manifestation of Wegener's granulomatosis or rheumatoid arthritis, and all patients with scleritis require a thorough systemic evaluation. Scleritis has a variable presentation and disease course, and may be an acute monophasic illness, a relapsing remitting process, or take a chronic course. Treatment options include local therapy with subconjunctival steroid injections for non-necrotising scleritis, and systemic anti-inflammatory or immunosuppressive therapy. Biologic agents have been used with success in some refractory cases. Ocular and systemic morbidity is reduced by timely treatment with immunosuppressant medications.
authors.affiliation: Department of Ophthalmology, Auckland District Health Board, Private Bag 92189, Auckland 1142, New Zealand. JoSims@adhb.govt.nz
authors.forename: Joanne
authors.initials: J
authors.lastname: Sims
mesh_terms: D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000150:complications / Q000188:drug therapy; D014890:Granulomatosis with Polyangiitis / Q000150:complications / Q000188:drug therapy; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D015423:Scleritis / Q000150:complications / Q000188:drug therapy* / Q000209:etiology*
chemical_list: D000893:Anti-Inflammatory Agents; D007166:Immunosuppressive Agents