Diseases of the Sclera

 Diseases of the Sclera

The sclera is the white outer coat of the eyeball that provides protection and structure. Several diseases can affect the sclera:

1. Episcleritis










Definition: Inflammation of the episclera (the thin layer over the sclera)

Symptoms: Redness, mild pain, tearing

Causes: Often idiopathic; sometimes linked to autoimmune conditions

Treatment: Usually self-limiting; artificial tears or mild anti-inflammatory drops


2. Scleritis


Definition: Severe inflammation of the sclera itself

Symptoms: Deep eye pain, redness, photophobia, vision loss (if untreated)

Types:

  • Anterior Scleritis (common)

  • Posterior Scleritis (less common, may cause vision changes)


Causes: Autoimmune diseases (e.g., rheumatoid arthritis, lupus)


Treatment: Oral NSAIDs, corticosteroids, or immunosuppressive drugs


3. Scleral Icterus

Definition: Yellowing of the sclera due to high bilirubin

Cause: Liver diseases like hepatitis or jaundice

Significance: Indicates systemic issue, not a primary eye disease

4. Scleral Degeneration

  • Senile Scleral Plaques:

  • Seen in elderly

  • Grayish areas near the rectus muscles

  • No symptoms or treatment needed

5. Blue Sclera:





  • Thinning of sclera reveals underlying pigment

  • Seen in conditions like osteogenesis imperfecta, Ehlers-Danlos syndrome


6. Scleral Staphyloma


Definition: Outward bulging of the weakened sclera

Cause: Trauma, surgery, inflammation, or high myopia

Effect: Vision loss if it involves posterior pole

Treatment: Often surgical


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