Scleritis vs. Episcleritis
| Feature | Episcleritis | Scleritis |
|---|---|---|
| Pain | Mild discomfort/foreign body sensation. | Severe, boring pain (often radiates). |
| Vasoconstriction | Blanches with phenylephrine 2.5%. | Does not blanch. |
| Severity | Benign, self-limiting. | Potentially sight-threatening. |
Scleritis High-Yield Pearls
- Association: Strongly linked to systemic autoimmune diseases (e.g., Rheumatoid Arthritis, Wegener’s Granulomatosis).
- Types: Anterior (diffuse, nodular, necrotizing) and Posterior (may show disc edema/choroidal folds).
- Management: Systemic NSAIDs or steroids; consider immunosuppressives for necrotizing cases.
Myopia (Nearsightedness)
In myopia, light focuses in front of the retina due to an elongated axial length or excessive refractive power.
- Pathological Myopia: Axial length > 26.5 mm or dioptric power > -6.00 D.
- Complications: Retinal detachment, myopic macular degeneration, posterior staphyloma, and open-angle glaucoma.
- Clinical Note: Myopes are prone to “myopic crescent” at the optic disc.
Clinical Connection
High myopia is a risk factor for scleral thinning and staphyloma. While not a direct cause of scleritis, the thinned sclera in extreme myopia can complicate the management of inflammatory scleral disorders.