What is the prognosis 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

Necrotizing scleritis, the most destructive type of scleritis, and scleritis with extensive scleral thinning or perforation convey less favorable prognoses than other types of scleritis. Prognosis of scleritis, when originating from systemic disorders, usually conforms to the course of the underlying disease. 

Morbidity arises from primary scleritis and associated systemic disease. In 15% of cases, scleritis is the presenting manifestation of collagen vascular disorder and may precede additional symptoms by one to several months. A significant percentage of patients with concurrent scleritis and collagen vascular disease die within 5 years.

One study demonstrated that spectral domain optical coherence tomography may be useful in following up on patient response to treatment. [23]

Scleral thinning leading to global perforation is the most devastating complication. Giant pigment epithelial tear and retinal detachment has been reported in a patient with scleritis. [24]  

Visual impairment is a possible complication. The cornea is affected more than 50% of time. Damage to the cornea may include uveitis, keratitis, glaucoma, and cataracts. [25]  Posterior chamber derangements may include the following:

  • Optic neuritis
  • Choroidal detachment
  • Macular edema
  • Retinal hemorrhage and/or detachment
  • Papilledema

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