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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.
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 .
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]
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.
Intraocular hemorrhage is classified based on the location of the bleeding: Hyphema (in the anterior chamber); Suprachoroidal hemorrhage (SCH) is a rare complication of intraocular surgery in which blood from the ciliary arteries enters the space between the choroid and the sclera.
Treatment consists of three phases of immunotherapy: 1. Acute phase: IV steroids (methylprednisolone 1 mg/kg) for 3–5 days or plasmapheresis are given to restore visual function. [3] 2. Intermediate phase: Oral steroids (typically prednisone 1 mg/kg) with taper are given to stabilize vision. [3] 3.
Enjoy a classic game of Hearts and watch out for the Queen of Spades!
Uveitis is an ophthalmic emergency that requires urgent control of the inflammation to prevent vision loss. Treatment typically involves the use of topical eye drop steroids, intravitreal injection, newer biologics, and treating any underlying disease.