Last revised by David Luong on 15 Feb 2022

Scleritis refers to inflammation of the sclera. It has a wide range of causes.

It can affect any age group but usually those between ages 30 and 50 years. There is a recognized increased female predilection (F:M of ~2:1).

Information on the pathogenesis of scleritis is limited due to a lack of published data. However, a predominant role for T cells in the inflammatory process has been postulated 1.

Scleritis can be associated with several systemic infections as well as non-infective systemic conditions which include 1:

One classification system is the Watson and Hayreh system which divides scleritis into anterior and posterior forms based upon the anatomic distribution.

  • anterior scleritis
    • diffuse anterior scleritis
    • nodular anterior scleritis
    • necrotizing anterior scleritis with inflammation
    • scleromalacia perforans (necrotizing anterior scleritis without inflammation)
  • posterior scleritis

Ocular ultrasound may play a role in the diagnosis and management of posterior scleritis.

CT and MRI imaging may also play a role in the diagnosis of scleritis especially during the active phase of the disease. Radiological findings include:7

  • scleral thickening
  • scleral enhancement
  • focal periscleral cellulitis

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Cases and figures

  • Case 1: posterior scleritis
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  • Case 2: posterior scleritis
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