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Scleritis can be classified as anterior scleritis and posterior scleritis. Anterior scleritis is the most common variety, accounting for about 98% of the cases. It is of two types : Non-necrotising and necrotising. Non-necrotising scleritis is the most common, and is further classified into diffuse and nodular type based on morphology.
Episcleritis is a benign, self-limiting condition, meaning patients recover without any treatment. Most cases of episcleritis resolve within 7–10 days. [2] The nodular type is more aggressive and takes longer to resolve. [2] Although rare, some cases may progress to scleritis. [13]
Management includes assessing whether emergency action (including referral) is needed, or whether treatment can be accomplished without additional resources. Slit lamp examination is invaluable in diagnosis but initial assessment can be performed using a careful history, testing vision (visual acuity), and carrying out a penlight examination.
If there is an underlying cause, treatment should be given based on the disease. Non specific treatment measures include cycloplegics , corticosteroids and immunosuppressive drugs . [ 2 ] The biologic drugs that are currently used in treatment of panuveitis include anti tumor necrosis factor , cytokine receptor antibodies and interferon-α .
Central retinal artery occlusion: CRAO is characterized by painless, acute vision loss in one eye. [11]Central retinal vein occlusion: CRVO causes sudden, painless vision loss that can be mild to severe.
Scleritis is a serious inflammatory disease of the sclera causing redness of the sclera often progressing to purple. Yellowing or a light green color of the sclera is a visual symptom of jaundice. In cases of osteogenesis imperfecta, the sclera may appear to have a blue tint, more pronounced than the slight blue tint seen in children.
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[11] [14] [9] Corneal transplantation is a management option when there is severe corneal melting or perforation although one possible disadvantage is the risk of rejection. [14] Surgical treatment helps maintain the integrity of the globe, but it is usually complementary because it alone cannot influence the underlying immunological process. [7]