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Scleritis is inflammation of the sclera, the tough outer wall of the eye. It often causes deep, aching pain and redness that does not feel like a mild irritation. Scleritis can be anterior (more visible) or posterior (deeper and harder to spot), and it can threaten vision when severe. Many cases link with systemic inflammatory disease, so evaluation often goes beyond the eye.
read more about scleritis ...Scleritis is often linked with autoimmune or inflammatory disease, including rheumatoid arthritis and vasculitis-related conditions. Inflammation damages scleral tissues and blood vessels, which drives pain and swelling. Infection can also cause scleritis, especially after surgery or trauma, and this form needs antimicrobial treatment rather than immune suppression. Less commonly, scleritis can follow local injury or appear without a clear systemic trigger. Identifying the cause matters because it shapes both medicine choice and long-term follow-up.
Deep eye pain that feels boring or aching is common, and it often worsens with eye movement. Redness usually looks violaceous and can involve a broad area rather than a single spot. Light sensitivity and tearing can occur, and vision can blur when inflammation spreads to the cornea, uvea, or retina. Some people develop headaches or facial pain because the sclera is richly innervated. Sudden vision drop, intense pain, or symptoms that wake you from sleep should be treated as urgent.
An eye doctor diagnoses scleritis with a detailed exam that evaluates scleral vessels, tenderness, and depth of inflammation. The clinician also checks for corneal thinning, uveitis, and elevated eye pressure, since these complications can occur with active disease. For posterior scleritis, imaging such as B-scan ultrasound can help confirm deeper inflammation when the surface looks less dramatic. Blood tests are often ordered when systemic disease is suspected, especially in recurrent or necrotizing forms. A thorough history also checks for recent surgery or trauma, which raises concern for infectious scleritis.
Treatment depends on severity and cause, and many cases need systemic therapy rather than drops alone. Noninfectious scleritis is often treated with oral anti-inflammatory medicine, then escalated to oral corticosteroids or immunosuppressive therapy when symptoms persist or necrotizing disease is present. If infection is suspected, targeted antibiotics or antifungals are used and immune-suppressing medicines are handled with caution. Supportive measures like lubricants can help surface discomfort, but they do not treat the underlying scleral inflammation. Close follow-up tracks response and checks for complications such as thinning and vision changes.
Episcleritis affects the superficial layer above the sclera and usually causes mild discomfort rather than deep pain. Scleritis involves deeper tissue, tends to hurt more, and carries higher risk of complications. Redness in scleritis often looks more violaceous and can be tender to touch. An eye exam can separate the two and guide treatment.
Yes. Many cases are associated with systemic inflammatory disease, and rheumatoid arthritis is a common link in adults. Vasculitis-related conditions can also be involved, especially in necrotizing forms. When scleritis is recurrent or severe, systemic evaluation is often part of care. Treating the systemic disease can reduce eye flares.
Yes. Posterior scleritis can cause pain and blurred vision without obvious surface redness. It can also mimic other causes of optic nerve swelling or retinal fluid. Imaging such as ultrasound can help confirm the diagnosis. Prompt diagnosis helps prevent avoidable vision loss.
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