Scleral icterus ttpp1/19/2024 ![]() Upon questioning, he reported chronic respiratory issues with a persistent cough for the past four to six months. His vision was correctable to 20/25- OD and OS, and his intraocular pressures were 18mm Hg OD and 19mm Hg OS. Although it was mostly superficial, there was some deeper episcleral inflammation noted. Slit-lamp exam showed bilateral sectoral nodular scleritis. He said his eyes had been getting red on and off, but this episode was much worse. A 66-year-old Indian male presented with bilateral red and mildly painful eyes. In this article, we present a few challenging cases of scleritis to highlight various treatment approaches and learning points. Posterior scleritis can also be nodular or diffuse and necrotizing, and involves the sclera posterior to the insertion of the rectus muscles. ![]() Scleral inflammation in a patient who had recent angle-closure glaucoma. It can be seen in patients with rheumatoid arthritis, granulomatosis with polyangiitis (formerly known as Wegener’s granulomatosis) and relapsing polychondritis. Necrotizing scleritis without inflammation, also known as scleromalacia perforans, is a very rare form of scleritis presenting with no symptoms.Necrotizing scleritis with inflammation is frequently associated with collagen vascular disorders causing destruction of the sclera.Nodular scleritis is characterized by a localized area of inflammation where a distinct nodule can be seen.Diffuse scleritis is widespread inflammation of the sclera, and the most common type.Scleritis can be classified as either anterior or posterior, where anterior scleritis can be further categorized into four different types: So, it’s vitally important to get to the bottom of this uncommon but aggravating condition. It’s often, but not always, associated with an underlying autoimmune disorder. Scleritis manifests as a very painful red eye-but it sometimes suggests that something deeper than the eye is involved.
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