Andrew A. Dahl, MD, is a board-certified ophthalmologist. Dr. Dahl's educational background includes a BA with Honors and Distinction from Wesleyan University, Middletown, CT, and an MD from Cornell University, where he was selected for Alpha Omega Alpha, the national medical honor society. He had an internal medical internship at the New York Hospital/Cornell Medical Center.
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
Scleritis is an inflammation of the white of the eye.
It is serious eye disease which is often associated with underlying autoimmune disorders.
Prompt diagnosis and treatment is essential in preventing permanent vision loss.
What is scleritis?
Scleritis is an inflammation of the sclera, the white portion of the eye.
What is the sclera?
The sclera is the tough, white fibrous outer wall layer of the eye. It is a type of connective tissue. The sclera provides both the white color of the eye and allows the eye to maintain its shape. It extends from the edge of the cornea (the clear, dome-shaped window in the front of the eye) all the way to the optic nerve in the back of the eye.
What causes scleritis?
Scleritis is an uncommon disease and is differentiated from episcleritis, which is a more common ocular condition. In episcleritis, only the superficial tissue between the white of the eye (sclera) and the blood vessel-filled covering (conjunctiva) is inflamed.
Approximately one-half of cases of scleritis are associated with underlying diseases that affect the body internally (systemic diseases). Connective tissue disorders, autoimmune diseases, and generalized vasculitic abnormalities may all first present as scleritis or manifest themselves as scleritis during the course of the underlying disease.
Scleritis may be the initial manifestation of these underlying illnesses. Some of these conditions are potentially lethal.
Scleritis can also be the result of an infectious process caused by bacteria including pseudomonas, fungi, viruses, or parasites. Trauma, chemical exposure, or postsurgical inflammation can also cause scleritis.
No cause is found in approximately 30% of cases of scleritis.
Scleritis may affect either one or both eyes. In patients with disease in both eyes, an underlying systemic cause is almost always found.
Reviewed by William C. Shiel Jr., MD, FACP, FACR on 1/9/2012
Scleritis: Inflammation of the sclera, the tough white outer coat of the eyeball.
Classic scleritis affects the sclera itself and is not a benign disease. It may impair vision. The principal symptom is severe general head pain. Scleritis occurs in association with systemic collagen diseases such as rheumatoid arthritis, Wegener's granulomatosis and, less often, lupus. The cause is unknown but when it occurs in the setting of one of these autoimmune diseases, the scleritis is generally thought to be due to the immune system attacking the sclera. Treatment is difficult. It may include administration of anti-inflammatory and cortisone-related medications either by mouth, intravenously, or even injected into the eye.
The term scleritis also includes episcleritis, inflammation of the episclera, a thin membrane that covers the sclera. Episcleritis is typically benign, easily treated and usually soon resolved.