Clinical Considerations of Episcleritis and Scleritis: The Massachusetts Eye and Ear Infirmary Experience

Abstract

Because episcleritis and scleritis are entities encountered infrequently in general ophthalmic practice, the diagnosis and subsequent treatment may be missed or delayed because of the relative lack of experience in their detection and management. Fraunfelder and Watsonl reported that in a series of 30 enucleated eyes (sent from hospitals from all parts of Great Britain) with a primary histological diagnosis of scleritis, the clinical diagnosis of scleritis had been missed in 12 (40%), often because the scleritis was masked by multiple complications such as uveitis, glaucoma, and keratolysis. Many of these 12 eyes had not received antiinflammatory treatment and many of the 18 eyes affected by clinical scleritis had received insufficient antiinflammatory treatment. The main reason for enucleation was pain with loss of vision. Many of these patients had had the ocular inflammation for up to 30 years before the enucleation.