Definição e significado de Scleritis

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  Scleritis: inflammation of entire thickness of the sclera.

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Scleritis is a serious inflammatory disease that affects the white outer coating of the eye, known as the sclera. The disease is often contracted through association with other diseases of the body, such as Wegener's granulomatosis or rheumatoid arthritis; it can also be attained through disorders of menstruation. For this reason, scleritis occurs frequently among young women. There are three types of scleritis: diffuse scleritis (the most common), nodular scleritis, and necrotizing scleritis (the most severe). Scleritis may be the first symptom of onset of connective tissue disease[1].

Episcleritis is inflammation of the episclera, a less serious condition that seldom develops into scleritis.^[1]

  Signs and symptoms

Symptoms of the disease include:^[2]

• Redness of the sclera and conjunctiva, sometimes changing to a purple hue
• Severe ocular pain (not present in episcleritis) which may radiate to the temple or jaw
• Photophobia and tearing
• Decrease in visual acuity, possibly leading to blindness

  Diagnosis

Scleritis is best detected by examining the sclera in daylight; retracting the lids helps determine the extent of involvement. Other aspects of the eye exam (i.e. visual acuity testing, slit lamp examination, etc.) can be normal. Ancillary tests CT scans, MRIs, and ultrasonographies can be helpful, but do not replace the physical examination.

  Treatment

In very severe cases of necrotizing scleritis, eye surgery must be performed to repair damaged corneal tissue in the eye and preserve the patient's vision. For less severe cases, nonsteroidal anti-inflammatory drugs, such as ibuprofen, are prescribed for pain relief. Scleritis itself is treated with an oral medication containing corticosteroids and an eye solution. In some cases, antibiotics are prescribed. Simply using eye drops will not treat scleritis. In more aggressive cases of scleritis, chemotherapy (such as systemic immunosuppressive therapy with such drugs as cyclophosphamide or azathioprine) may be used to treat the disease. If not treated, scleritis can cause blindness.

  External links

• Scleritis at MERSI.com
• Scleritis article at StLukesEye.com
• Scleritis article at Merck.com

  End Notes

  References

• Sainz de la Maza, Maite, MD, PhD "Scleritis", eMedicine.com, September 26, 2006. Accessed June 12, 2007.

• Goldstein DA, Tessler HH. Episcleritis and scleritis. In: Yanoff M, Duker JS, eds. Ophthalmology. 3rd ed. St. Louis, Mo: Mosby Elsevier; 2008:chap 4.11.

• Rosenbaum JT. The Eye and rheumatic diseases. In: Firestein GS, Budd RC, Harris ED Jr, et al., eds. Kelley's Textbook of Rheumatology. 8th ed. Philadelphia, Pa: Saunders Elsevier; 2008:chap 46.

• Watson P. Diseases of the sclera and episclera. In: Tasman W, Jaeger EA, eds. Duane’s Ophthalmology. 15th ed. Philadelphia, Pa: Lippincott Williams & Wilkins; 2009:chap 23.