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When we see the white part of the eye, we are actually looking through a clear membrane called the CONJUNCTIVA, to another semi-clear layer underneath, called the EPISCLERA. The episclera is a tough membrane which covers the entire eyeball. We can see through the episclera also, to the visible white outer surface of the eyeball called the SCLERA. Any of these three layers can become inflamed. Conjunctival inflammation, called
CONJUNCTIVITIS, is frequently caused by a virus or bacteria (this
condition is the well-known "pinkeye"). Sometimes, however,
conjunctival inflammation is more severe and is part of an auto-immune
process affecting the whole body. Examples of this are two severe
conditions: STEVENS-JOHNSON SYNDROME (SJS) and OCULAR CICATRICIAL
PEMPHIGOID (OCP). Both of these conditions involve inflammation
of the mucous membrane surfaces (eyes, mouth and sometimes the genitals)
and can be quite debilitating, causing dry eyes and long-term complications.
Inflammation of the episclera, or EPISCLERITIS, manifests as redness of the eye and is generally not painful or only slightly uncomfortable. By contrast, SCLERITIS, which also causes redness of the eye, is quite painful. Scleritis can sometimes be a manifestation of AUTOIMMUNE DISEASES, including RHEUMATOID ARTHRITIS, WEGENER'S GRANULOMATOSIS, or SYSTEMIC LUPUS ERYTHEMATOSIS. When treating scleritis, ophthalmologists always evaluate patients for rheumatoid diseases, since this determination assists in directing therapy. The treatment of ocular
surface inflammation depends on the severity. For mild inflammation
such as episcleritis or conjunctivitis, eyedrops are often sufficient.
Various types of drops, including steroids, may be used, depending
on the suspected cause of the inflammation, and these conditions
tend to run a benign course. The treatment of severe ocular surface
inflammation-scleritis is always considered severe inflammation--requires
systemic medication, such as NSAIDS, oral or IV steroids, or IMMUNOMODULATORY
THERAPY. |
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