What are the types of scleritis?

Updated: Feb 08, 2021
  • Author: Theodore J Gaeta, DO, MPH, FACEP; Chief Editor: Barry E Brenner, MD, PhD, FACEP  more...
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Answer

The 4 types of anterior scleritis are as follows:

  1. Diffuse anterior scleritis: This is characterized by widespread inflammation of the anterior portion of the sclera. It is the most common form of anterior scleritis as well as the most benign.

  2. Nodular anterior scleritis: This type is characterized by one or more erythematous, immovable, tender inflamed nodules on the anterior sclera. Approximately 20% of cases progress to necrotizing scleritis.

  3. Necrotizing anterior scleritis with inflammation: This form frequently accompanies serious systemic collagen vascular disorders including rheumatoid arthritis. [4]  Pain with this condition is usually extreme, and damage to the sclera is often marked. Necrotizing anterior scleritis with corneal inflammation is also known as sclerokeratitis.

  4. Necrotizing anterior scleritis without inflammation: This type most frequently occurs in patients with long-standing rheumatoid arthritis; it is due to the formation of a rheumatoid nodule in the sclera and is notable for its absence of symptoms. Necrotizing anterior scleritis without inflammation is also known as scleromalacia perforans.

Necrotizing anterior scleritis is the most severe form and most common form of scleritis with vision-threatening complications and resultant permanent visual loss. [5]  In cases of non-necrotizing scleritis, vision is often maintained unless complications such as uveitis occur. [6]

Posterior scleritis occurs much less frequently than anterior scleritis, but the two disorders may occur concurrently. [7] Posterior scleritis has been reported to mimic orbital cellulitis. [8] It is characterized by flattening of the posterior aspect of the globe, thickening of the posterior coats of the eye (choroid and sclera), and retrobulbar edema. [9]


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