Scleral Disease

China Medical University NO.4
Affiliated hospital Ophthalmology;
Ophthalmology hospital of China
Medical University

Introduction

character
• Outer wall of eye.
• Collagen fiber & elastic fiber
• Lack of cell and vessels
• Less capacity of self repairing—staphyloma

Scleral Disease : Commonly found in inflammation
( disease course deferment , medication inevident )
Scleral Disease Classifications :
Episcleritis
Scleritis

Episcleritis Nodular episcleritis : acute in onset symptoms:unilateral 、 wine 、 round or ellipse limited nodular uplift , diameter 2 ~ 3mm redness 、 edema irritation Vission not affected concurruent mild iritis the inflammation subsided in 2 to 4 weeks , easily recurrent 。 .

Episcleritis Simple episcleritis : periodicity redness and edema light irritation.Vission not affected concurruent lid edema , disease course deferment often found in Women's menstrual period self-limited .

Episcleritis different diagnoses Episcleritis Conjunctivitis scleritis Congestion Localized Diffused. palpebral conjunctiva affected Congestion Not affect sclera Affect and edema sclera Nodules movable unmovabl e Adrenaline Disappear Disappear Not disappear .

Episcleritis Treatment : • Self-limiting • Corticosteroids: – Eyedrop – ic • NSAIDs: po .

. granulomatous or metabolic diseases. Scleritis • Inflammation of sclera • Severe than episcleritis • Young and mid-age adults • Female>Male • Autoimmune disease • Complicated with general collagenous.

Scleritis pathogeny : Allergic reaction 。 Auto immune connective tissue diseases Metabolic diseases Other : infection spreaded , inflammation spreads in the vicinity of the organization 。 .

Vision decrease 、 sclera focus course : long 、 recurrent 、 deferment prognosis : not good complications : Uveitis 、 Keratitis 、 Secondary glaucoma e.g 。 . Scleritis anterior Scleritis: disease site : anterior equator , bilateral eyes current successively 。 clinical manifestations : pain.

Scleritis Classification diffuse anterior scleritis nodular anterior scleritis necrotizing anterior scleritis .

diffuse anterior scleritis about 40 % prognosis preferably sclera diffuse redness bulbar conjunctiva edema .

diffuse anterior scleritis .

nodular anterior scleritis about 44 % Scleral lesions dark red inflammation Infiltrated nodular Uplift , hard , pain concurruent Episcleritis .

nodular anterior scleritis .

lark nodula perforated scleromalacia perforans often bilateral eyes concurruent Serious Autoimmune diseases . necrotizing anterior scleritis often Vision decrease , about 14 % pain , Rapid development occlusive vasculitis , sclera necrosis areas of avascularity.

necrotizing anterior scleritis .

g 。 diagnoses : Examinations , such as B-US 、 CT 、 MRI.can show Posterior sclera thickening 。 different diagnoses : Orbital cellulitis , the symptoms and exophthalmus are even Obvious 。 . Scleritis Posterior Scleritis: disease site : Posterior equator , about 2 %。 clinical manifestations : pain , eyelid and bulbar conjunctiva edema , eyeball slightly Prominent , extraocular involved 。 Concurruent Uveitis 、 Vitreous opacities e.

Scleritis treatment • Pathogeny treatment • Symptomatic treatment : coldly cover 、 Artificial tears 。 • Anti-inflammatory treatment : corticosteroids 、 Immunosuppressant e. .g 。 • Surgical treatment : necrosic 、 perforative Scleral site can be done with Allogeneic scleral graft 。 • Complications treatment : glaucoma 、 Iridocyclitis.

and revealed blue-black color of uveal color 。 • Classification : anterior sclera staphyloma equatorial sclera staphyloma posterior sclera staphyloma . Sclera staphyloma • definition : Because of thinning of the sclera , sclera and deep uveal bulge and expand outward with the function of intraocular pressure.

• treatment : 1. If the eyes have been suffering from no light perception , And pain , eyes can be removed 。 . Decompression early 2.

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Abnormal scleral color • Scleral pigment plaques : brown or blue- gray spots currented at anterior sclera surface and entrance of Ciliary vessels 。 Scleral melanosis syndrome 。 • Blue sclera : It is caused by Uveal color under sclera because of thin sclera 。 concurruent congenital anomalies • Sclera yellow Stained : Jaundice • Brown macular:Brown-gray spots at sclera , which current at Palpebral fissure area earliest 。 It can be distributed in the sclera. cornea and conjunctiva 。 No clinical significance 。 .