Scleritis--Please Post

[Guest guest]

This is a condition which I was diagnosed with about six years ago,

shortly after my silicone gel ruptures. I wanted to share this info I

have found about it in case some of you are experiencing the same thing.

I usually have flare ups in the winters, and they are extremely painful

and irritating.

If you have this, do not neglect it...go to an opthalmologist at once to

have it diagnosed and treated.

God Bless,

Lany

Reference: The Merck Manual

http://www.merck.com/pubs/mmanual/section8/chapter95/95e.htm

The Merck Manual of Diagnosis and Therapy   Section 8.

Ophthalmologic Disorders    Chapter 95. Conjunctival

Disorders Topics [General] Acute Conjunctivitis Chronic Conjunctivitis

Episcleritis Scleritis Cicatricial Pemphigoid

Scleritis

A severe, destructive, vision-threatening inflammation involving the

deep episclera and sclera. [MY NOTE: THE SCLERA IS THE 'WHITE' PART OF

YOUR EYE, AND WITH SCLERITIS, THE SCLERA BECOMES EXTREMELY RED,

SENSITIVE, AND IRRITATED.]

Scleritis is most common in the 4th to 6th decades and affects women

more often than men.

Symptoms and Signs

Patients complain of a pain (most often characterized as a deep, boring

ache) so extreme that it often interferes with sleep and appetite.

Patients also complain of tenderness, photophobia, lacrimation, and

localized or generalized conjunctival hyperemia. The patch of hyperemia

is deep beneath the conjunctiva and is more bluish than that seen with

episcleritis. The surrounding and overlying bulbar conjunctiva is

hyperemic, and because only the globe is involved, the palpebral

conjunctiva is normal. The involved area may be sectoral or widespread

(diffuse scleritis); contain a hyperemic, edematous, raised nodule

(nodular scleritis); or contain an avascular area (necrotizing

scleritis). Fourteen percent of patients with scleritis lose significant

visual acuity within 1 yr. In severe cases of necrotizing scleritis,

perforation of the globe and loss of the eye may ensue. An associated

connective tissue disease may occur in 20% of patients with diffuse or

nodular scleritis and in 50% of patients with necrotizing scleritis.

When necrotizing scleritis occurs in association with RA, there is a

mortality rate of up to 50% in 10 yr (mostly from MI), which can be

greatly reduced by cytotoxic immunosuppression.

Treatment

A systemic corticosteroid (eg, prednisone 1 mg/kg/day) is the initial

therapy. If the scleritis is unresponsive to systemic corticosteroids or

when the patient has necrotizing scleritis and RA, systemic

immunosuppression with drugs such as cyclophosphamide or azathioprine

may be indicated. Such treatment requires close monitoring of the

hematopoietic, renal, and other organ systems and should be undertaken

only in consultation with a specialist experienced in using these drugs.

Copyright © 1995-2001 Merck & Co., Inc., Whitehouse Station, NJ,

USA. All rights reserved.

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