What causes 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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Scleritis coexists with a serious systemic disease in almost one half of cases; the underlying problem is frequently a connective tissue disorder. [12] Rheumatoid arthritis (RA) is the underlying disease for approximately one sixth of patients suffering from scleritis, and approximately 1% of patients with RA will develop scleritis at some point in the course of the disease. Scleritis associated with RA is due to the development of a rheumatoid nodule on the sclera and is associated with an increased risk of mortality. [12]

Other connective tissue and autoimmune diseases seen with scleritis include the following: [12]

  • Systemic lupus erythematosus (SLE)
  • Polyarteritis nodosa
  • Seronegative spondyloarthropathies - Ankylosing spondylitis, psoriatic arthritis, reactive arthritis
  • Granulomatosis with polyangiitis (Wegener granulomatosis)
  • Relapsing polychondritis [14]
  • Sarcoidosis
  • Inflammatory bowel disease
  • Sjögren syndrome
  • IgG4-related disease [15]

Additional causes of scleritis include the following:

  • Syphilis [16]
  • Post–herpes zoster ophthalmicus
  • Poststreptococcal syndrome [17]
  • Tuberculosis
  • Gout
  • Lyme disease
  • Foreign body
  • Hypertension

Surgically-induced scleritis is a rare complication following ophthalmologic procedures such as the following:

  • Cataract surgery
  • Pterygium excision
  • Strabismus surgery
  • Retinal detachment repair [18]
  • Intravitreal injection [19]

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