Scleritis And Episcleritis

Scleritis: Scleritis is an inflammatory disease of the sclera. It is an immune-mediated

vasculitis that delays the sclera.

Causes:

1. Rheumatoid Arthritis
2. Inflammatory Bowel disease
3. Ankylosing spondylitis
4. Syphilis and Tuberculosis
5. Sarcoidosis
6. Giant cell arteritis
7. Herpes Zoster infection
8. Polyarteritis Nodusa
9. Systemic Lupus Erythematosus
10. Wegner Granulomatosis

Management:

1. It is treated by relieving underlying systemic disease

2. Topical steroids
3. Systemic NSAIDs
4. Systemic Steroids
5. Triamcinolone

Episcleritis: It is defined as an inflammation of the episcleritis tissue. It is often recurrent

and non-inflammatory.

Causes:

1. Rheumatoid Arthritis
2. Inflammatory Bowel disease
3. Acne rosacea
4. Atopy
5. Gout
6. Syphilis and Tuberculosis

Management:

1. Generally self-limiting
2. Topical vasoconstrictors
3. Topical Corticosteroids
4. Oral NSAIDs
 Orbital Cellulitis

Definition: It is an acute infection of the orbital soft tissues posterior to the orbital septum. It
is an ophthalmic emergency that may cause loss of vision and even loss of life.
It can occur at any age but is more common in common.

Causes:

1. Extension of the infection from pre-orbital soft tissue

2. Sinusitis
3. Pre-septal Cellulitis
4. Acute Hordeolum
5. Dacryocystitis
6. Dental Infection
7. Bacteremia
8. Penetrating injury
9. Blow out fracture
10. End ophthalmitis

Management:

Proper investigations are done to make a diagnosis.

1. Blood CP, ESR, Blood Culture, Orbital Ultra Sonography, X-Rays, and CT-Scan.
2. Systemic antibiotics are given
3. NSAIDs to control pain and inflammation.
 Acute Congestive Glaucoma

Definition: Acute angle-closure glaucoma is an ocular emergency that results from a rapid
increase in transocular pressure due to outflow obstruction of aqueous humor.
It presents as a sudden onset of severe unilateral eye pain or headache associated with
blurred vision, rainbow-colored halos around bright lights, nausea, and vomiting.

Causes:

Several factors lead to the obstruction of aqueous humor.

1. Shallow Anterior chamber

2. Lens size
3. Anterior location of Iris-Lens Diaphragm
4. Corneal diameter
5. Sex, Race, etc.

Management:

1. IV Acetazolomide (to block the production of aqueous humor)

2. IV Mannitol (to decrease the volume of aqueous humor)
3. Topical beta-blockers
4. Peripheral iridectomy is the choice of treatment to prevent recurrence