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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

     

    In contrasting the presentation of scleritis with that of episcleritis, Dr. de Luise said the latter is a self-limited disease of the episclera.

    “In episcleritis, the inflammation is superficial, and the sclera is minimally engorged, if at all,” he said.

    Patients usually have a history of allergy. Episcleritis can be divided into two types: simple (diffuse) and nodular. Although episcleritis is usually idiopathic, it may be associated with trauma, gout, atopy, rheumatoid arthritis, lupus, or inflammatory bowel disease. There is rarely an anterior chamber reaction in episcleritis.

    There is also a related form, called pingueculitis, where the episcleritis manifests as an inflamed pinguecula, he said.

    Treatment for mild episcleritis includes sunglasses and artificial tears. If the patient has itching, the specialist can recommend topical anti-allergics. For discomfort, Dr. de Luise advised the use of topical NSAIDS. In recalcitrant cases, oral NSAIDs such as indomethacin 75 to 100 mg orally per day, and/or topical pulsed corticosteroids, can be used.

     

     

    Vincent de Luise, MD, FACS

    E-mail: [email protected]

    This article was adapted from Dr. de Luise’s presentation during Cornea Subspecialty Day at the 2014 meeting of the American Academy of Ophthalmology. Dr. de Luise did not indicate any proprietary interest in the subject matter.

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