Affiliation:
1. University of Waterloo School of Optometry and Vision Science
Abstract
The sclera, serving as the eye’s outer opaque covering, played a vital role in preserving the integrity of the eyeball and providing attachment points for muscles. Beyond its function in safeguarding front surface structures, it also integrates with the optic nerve head. Scleral irregularities encompassed variations in coloration, such as ocular melanosis and jaundice, instances of inflammation, such as episcleritis and scleritis, and surgical modifications like scleral buckle and filtering bleb procedures. Inflammation of the sclera, while not an uncommon occurrence, necessitated a crucial distinction between episcleritis and scleritis to ensure swift management, treatment, and prognosis assessment. A 46-year-old Caucasian male presented with a painful, red, and watery right eye. He notes no previous trauma or medical conditions other than a potential for hypothyroidism. Examination revealed pain with eye movement, tenderness around the adnexa, significant conjunctivochalasis, and 4+ bulbar hyperemia that did not blanch completely with 2.5% phenylephrine. A diagnosis of anterior diffuse scleritis was made, and treatment began with Pred Forte ® and Aleve ®. He was then referred to the family doctor for further testing to rule out underlying systemic conditions. Scleritis is a noteworthy inflammatory disorder due to its propensity to cause complications which could impair eyesight and its correlation with systemic immune-mediated illnesses. The severity of presentations may vary, and scleritis has the potential to serve as the first indication of systemic autoimmune disorders. Hence, it is essential to do a comprehensive examination of the patient’s medical history, examine their systems, and perform specific laboratory investigations for all individuals. The timely detection of individuals with concomitant systemic illnesses may play a crucial role.