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    Early intervention considered key in diagnosis and treatment of scleritis

    Collaboration with rheumatologists key if biologics used for this sight-threatening disease


    Pain is a distinguishing factor between scleritis and episcleritis, Dr. de Luise said.

    “If there is pain, consider scleritis; if it’s just itching, consider episcleritis,” he said.

    Click to read more clinical diagnosis news

    In an examination under natural light, patients with scleritis will have a bluish-red discoloration in the area with scleritis. Using neosynephrine 2.5%, vessels will blanch with episcleritis but not scleritis.

    Ocular sequelae for scleritis include cataract, glaucoma, uveitis, and peripheral ulcerative keratitis.

    Laboratory testing can help identify the type of scleritis, Dr. de Luise said.

    Depending on the history, testing should include rheumatoid factor, anti-nuclear antibodies, human leukocyte antigen, anti-neutrophilic cycloplasmic antibodies, and tests for tuberculosis, Lyme disease, sarcoidosis, and gout. Imaging tests include CXR, B-scan, sinus films, and CT or MRI tests.

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