Scleritis is a deep, extremely painful inflammation and purple discoloration of the sclera (the white of the eye) that may severely damage vision.

Scleritis is most common among people aged 30 through 60 and affects women more often than men. In one third of cases, it affects both eyes. Scleritis may accompany rheumatoid arthritis, systemic lupus erythematosus, or another autoimmune disorder. About half of the cases of scleritis have no known cause.

Symptoms include pain in the eye (typically a deep ache) that often interferes with sleep and reduces appetite. Other symptoms include eye tenderness, increased watering of the eye, and sensitivity to bright light. Redness occurs over part or all of the eye. Rarely, inflammation is severe enough to cause perforation of the eyeball and loss of the eye.

Doctors diagnose scleritis by its symptoms and appearance during a slit-lamp examination. Sometimes the area of inflammation is in the back part of the eye (posterior scleritis), and an ultrasound or computed tomography (CT) scan is needed to confirm the diagnosis.

Doctors treat scleritis with topical conrticosteroid eye drops. Sometimes, oral corticosteroids or nonsteroidal anti-inflammatory drugs (NSAIDs) taken by mouth are necessary. If the person has rheumatoid arthritis or does not respond to corticosteroids, drugs that suppress the immune system, such as cyclophosphamide or azathioprine, may be needed.

Last full review/revision June 2008 by Mitchell H. Friedlaender, MD