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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 .
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.
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 .
The prognosis is generally good for those who receive prompt diagnosis and treatment, but serious complication including cataracts, uveitic glaucoma, band keratopathy, macular edema and permanent vision loss may result if left untreated. The type of uveitis, as well as its severity, duration, and responsiveness to treatment or any associated ...
[3] [6] [4] [8] [9] The most common forms of ocular involvement are usually mild and often consist of unilateral or bilateral episcleritis and/or scleritis, that is often anterior and could be lingering or relapsing. [3] [4] Scleritis that is necrotizing is found to be exceedingly rare. [3] Less often, conjunctivitis occurs.
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.