Signs and Symptoms of Scleritis

Signs and Symptoms of Scleritis

Scleritis is an immune mediated granulomatous inflammation of sclera which consists about 80% of exterior of eye ball. Women are usually affected by this disease in their 6^th and 7^th decade. There is dense infiltration of scleral tissues by lymphocytes found as a result of the outcome of this disease. This disease can be classified into two main types: i) Anterior scleritis and ii) Posterior scleritis. Where anterior scleritis affects 95% of the people, posterior scleritis affects only 5% people. There are several causes which are responsible for the outcome of this disease. The causes are divided into two categories i) exogenous agents ii) endogenous agents. 

The exogenous agents includes viruses –HSV, VZV, EBV etc. have direct cytopathic effect and they or their components induce antigens that invoke an immune response, bacteria& mycobacteria, fungi, protozoa. The endogenous agents includes immunological cross reactivity of glycosaminoglycan, collagen between sclera and other organ suggest auto immunity. The main diagnostic test used to identify this disease is blood & urine test. The following tests are performed regarding blood as well as urine to detect this disease such as: Rh factor test, Anti CCP test, ANA, ANCA test, CIC, complement, HLA typing, Ab against infectious agents. Surgical treatment may also be an effective treatment for this disease which has the ability to cure the disease totally within a short time of recovery period.

      

Several unique symptoms are usually exhibited by this disease as it affects the exterior part of the eye which is sclera. The effect of this disease is usually varies less from person to person having this same disease. 

Some symptoms which are mostly reported are discussed in the following:

 

• ·         Widespread inflammation, Distortion of vascular pattern, Benign progression is exhibited in case of diffused scleritis.
• ·         Nodular appearance as well as intermediate severity may be found if the person gets affected by nodular scleritis.
• ·         Anterior necrotizing scleritis with patches exhibits some other symptoms like distortion or occlusion of blood vessels, development of scleral necrosis, gradual spread of necrosis around the globe which may finally results into cataract or glaucoma too.
• ·         Anterior necrotizing scleritis without patches has features like starting of a yellow necrotic patch & large area of uvea becomes exposed.
• ·         Eyelid oedema, proptosis, opthalmoplegia which is followed by associated anterior scleritis in some cases where the physiological state finally lead to posterior scleritis.
• ·         Sclera and conjunctiva become red which sometime changed to purple due also in the later stages of this disease.
• ·          Severe ocular pain occurred which sometimes spread to temple and jaw too and this pain can only be quite decreased for a short period of time by the use of pain killers.
• ·         As the disease starts affecting the visual activity also start decreasing which finally results into blindness too if not treated on time.
• ·         Unusual tearing occurred which is followed by photophobia.
• ·         A disorder in the connective tissue which is followed by rheumatoid arthritis in the later stage is found in the patients who are severely affected by this disease.