Scleritis

What is Scleritis?
Scleritis is an inflammatory disease that affects the conjunctiva, sclera, and episclera (the connective tissue between the conjunctiva and sclera). It is associated with underlying systemic diseases in about half of the cases. The diagnosis of scleritis may lead to the detection of underlying systemic disease. Rarely, scleritis is associated with an infectious problem.

The affected area of the sclera may be confined to small nodules, or it may cause generalized inflammation. Necrotizing scleritis, a more rare, serious type, causes thinning of the sclera. Severe cases of scleritis may also involve inflammation of other ocular tissues.

Scleritis affects women more frequently then men. It most frequently occurs in those who are in their 40's and 50's. The problem is usually confined to one eye, but may affect both.

Common symptoms are: blurred vision, double vision, sensitivity to light (photophobia) and eye pain. You may also experience tears in the surface of the sclera, patches may turn red or violet or the sclera may lose its normal coloring. If you experience any of these symptoms, schedule an appointment with your eye doctor immediately.

The affected area of the sclera may be confined to small nodules, or it may cause generalized inflammation. Necrotizing scleritis, a more rare, serious type, causes thinning of the sclera. Severe cases of scleritis may also involve inflammation of other ocular tissues.

DETECTION AND DIAGNOSIS
Along with visual acuity testing, measurement of intraocular pressure, slit lamp examination, and ophthalmoscopy, the doctor may order blood tests to rule out diseases affecting the body. If involvement of the back of the eye is suspected, the doctor may order imaging tests such as CT Scan, MRI, or ultrasonography of the eye.

What is the sclera?

The sclera is the white part of your eye. Made out of fibrous tissues that are similar to those found in joints, the sclera extends from the front of your eye to the back where the optic nerve resides.

Unlike the cornea, which is clear, the sclera is an opaque white color. In children it may be more see-through, showing more of the tissue underneath. This may give the sclera a bluish tint. In adults, the sclera can be a bit more yellow.

The sclera is held in place by six tiny muscles. It is a strong, protective part of your eye.

What does the sclera do?

To know what the sclera does, it's helpful to know what the other parts of your eye do as well. You can imagine your eye to be like a camera. A camera has a bunch of different parts that work together to take pictures, just like your eye has many different parts- most of which we can't see when we look at our own eyes.

Our eyes' iris is like the shutter. The shutter is what controls how much light comes into a camera. The pupil is like the opening of the camera. The iris controls how much light enters through the pupil. In the back of the eye, we have the retina- just like the back of a camera has a layer of light-sensitive film. The film coating can be compared to the rods and cones that send the data about what we're seeing to our brain. Our eyes' lens is just like a camera lens, controlling what we're focusing on and how we're focusing on it.

The sclera is like the camera body- protecting all the sensitive working parts inside from getting damaged. It also keeps any light from getting into the eye. If you've ever used a film camera and opened the back before the roll was finished, you know how you can ruin film by exposing it to too much light. Similarly, if our eyes allowed light to get in through the whites, we'd have too much light bouncing around to make a cohesive picture. The sclera is an important working part of the eye.

What diseases or other problems can affect my sclera?

Luckily, not a lot of diseases affect the sclera. As we learned above, the sclera is designed to be a protective part of your eye. It's pretty sturdy. That doesn't mean it can't become damaged, injured or diseased. When the sclera does become diseased, it may happen very quickly, so it is very critical to see an eye doctor right away, before problems get worse.

Scleritis: The suffix “itis” comes from Greek and means “inflammation”. So when you see a medical term like “appendicitis”, you can guess it means “inflammation of the appendix”. Hepatitis, pancreatitis, and bronchitis are some other good examples. Hepatitis is inflammation of the liver, pancreatitis is inflammation of the pancreas and bronchitis is inflammation of the mucus membranes in the bronchial tubes.

FYI: Episcleritis
Episcleritis is actually an inflammation of the thin membrane covering the sclera. If you know that derm means skin and epidermis is the outer layer of skin, you can guess what “episclera” means.

Symptoms of episcleritis include pink or purplish tinge to a normally white part of the eye, a tear in the eye, sensitivity to light, eye pain and eye tenderness.

Episcleritis is more common in children. If your child complains of a burning pain in part of his eye, it’s best to keep him from rubbing it and rinse the area with saline. If you don’t have saline, use clear fresh water. Never prod, poke or put pressure on the eye. Only an ophthalmologist is qualified to examine and diagnose what is causing the pain. Make an appointment immediately if you or your child experience any of these symptoms.