Which clinical history findings are characteristic 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

Scleritis is subacute; with a more gradual onset than in episcleritis. [26]  Scleritis generally persists from months to years, whereas episcleritis usually resolves within weeks. Both eyes are affected in slightly more than one half of cases.

Severe, constant, deep, boring, or pulsating pain is noted. Pain worsens with movement of the eye and is worse at night and may awaken the patient. Pain may be referred to the eyebrow, temple, or jaw. Occasionally, the configuration of the pain pattern corresponds to the course of the trigeminal nerve.

Erythema of the eye is a defining symptom with anterior scleritis. Other signs and symptoms include lacrimation and photophobia. Discharge is ordinarily not part of the clinical picture of scleritis. Less common manifestations include nausea/vomiting and headache

Prior history may include underlying systemic disease [12] , trauma, ocular surgery, glaucoma, exposure to irritants/chemicals, previous use of eye drops and medications. Uncommonly, patients may report similar previous episodes.


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