Full thickness inflammation of the sclera; more serious than episcleritis

Aetiology

• There is an associated systemic condition in around 50% of patients presenting with scleritis e.g. rheumatoid arthritis, SLE, IBD, sarcoidosis, GPA
• Surgery and infections can also be responsible

Clinical features

• Severe pain that progresses over several days
• Pain with eye movement
• Photophobia
• Eye watering
• Reduced visual acuity
• Abnormal pupil reaction to light
• Tenderness to palpation of the eye

Investigations

• Urine dipstick: to identify renal disease
• Bloods:
  • FBC, CRP, U&Es, LFT to identify anaemia of chronic disease, neutrophilia, renal function
  • Autoimmune serology

Management

• Oral NSAIDs
• Oral steroids + steroid sparing agents