Hello and welcome to the zero to finals podcast. My name is Tom and in this episode I'm going to be

talking to you about scleritis. And if you want to follow along with written notes on this topic,

you can follow along at zero to finals.com slash scleritis or in the ophthalmology section of the

zero to finals medicine book. Let's get straight into it.

Scleritis involves inflammation of the full thickness of the sclera and this is more serious than

episcleritis which is just the superficial layer of the sclera. Scleritis is not usually caused by infection.

The most severe form of scleritis is called necrotizing scleritis,

and most patients with necrotizing scleritis have visual impairment but may not have pain.

And it can lead to perforation of the sclura.

Perforation of the sclera is the most significant complication of scleritis.

There's a few associated systemic conditions that can be related to scleritis.

And there's an associated systemic condition in about 50% of patients who present with scleritis and this may be rheumatoid arthritis,

systemic lupus erythematosis, inflammatory bowel disease, sarcoidosis or granulobotosis with polyangitis.

So how do patients present? Well scleritis usually presents with an acute onset of symptoms.

Around 50% of cases are bilateral, with the other 50% being unilateral,

and patients present with severe pain, pain on eye movement, photothobia, eye watering,

reduced visual acuity, abnormal pupil reactions to light, and they'll have tenderness

on palpation of the eye. So how do we manage scleritis? Well the nice clinical knowledge

summaries on red eye say that patients with potentially sight-threatening causes of a red eye

should be referred for same-day assessment by an ophthalmologist,

and scleritis is one of those conditions.

So if a patient presents with a red eye,

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