DISEASES OF SCLERA

Definition: Scleral diseases refer to various conditions affecting the sclera, the white fibrous coat of the eye.
Types:
- Scleral thinning
- Scleral thickening
- Scleral calcification
- Scleral ulcer
- Scleral perforation
Causes:
- Trauma
- Infections
- Autoimmune disorders
- Inflammatory conditions
- Metabolic disorders
- Aging
Clinical Features:
- Visual disturbances
- Eye pain
- Redness
- Swelling
- Scleral thinning or thickening
- Ulceration
- Perforation
Investigations:
- Ophthalmoscopy
- Slit-lamp examination
- Imaging studies (CT or MRI)
- Blood tests (for infections or autoimmune disorders)
Complications:
- Vision loss
- Scleral rupture
- Endophthalmitis
- Orbital cellulitis
- Scleral erosion
Management:
- Conservative management (for mild cases)
- Surgical intervention (for severe cases)
- Antibiotic therapy (for infections)
- Anti-inflammatory medications (for inflammatory conditions)
- Supportive care (for complications)

PATHOLOGY

Scleral diseases can be classified into two categories:
- Primary scleral diseases (e.g., scleral thinning, scleral thickening)
- Secondary scleral diseases (e.g., scleral calcification, scleral ulcer)
The sclera is composed of elastin, collagen, and other extracellular matrix components
Scleral diseases can result from damage to the scleral connective tissue or the overlying epithelium

CLINICAL FEATURES

INVESTIGATIONS

Ophthalmoscopy:
- Visual examination of the sclera
- Detection of scleral thinning or thickening
- Detection of scleral ulcer or perforation
Slit-lamp examination:
- Detailed examination of the sclera
- Detection of scleral thinning or thickening
- Detection of scleral ulcer or perforation
Imaging studies (CT or MRI):
- Detection of scleral calcification
- Detection of scleral thinning or thickening
- Detection of scleral ulcer or perforation
Blood tests:
- Detection of infections or autoimmune disorders

COMPLICATIONS

Vision loss:
- Due to scleral rupture or perforation
- Due to endophthalmitis or orbital cellulitis
Scleral rupture:
- Due to trauma or infection
- Can lead to vision loss or endophthalmitis
Endophthalmitis:
- Due to infection or trauma
- Can lead to vision loss or scleral rupture
Orbital cellulitis:
- Due to infection or trauma
- Can lead to vision loss or scleral rupture
Scleral erosion:
- Due to trauma or infection
- Can lead to vision loss or scleral rupture

Structure of Sclera

The sclera is the white, outer layer of the eyeball.
It provides protection and structure to the eye.
The sclera is composed of collagen and elastin fibers.
It has four layers: the episclera, the scleral stroma, the scleral lamina, and the scleral epithelium.
The episclera is the outermost layer, composed of loose connective tissue.
The scleral stroma is the middle layer, composed of collagen and elastin fibers.
The scleral lamina is a thin layer of dense connective tissue.
The scleral epithelium is the innermost layer, composed of endothelial cells.

Episcleritis

Episcleritis is inflammation of the episclera.
Types:
- Simple episcleritis
- Nodular episcleritis
- Diffuse episcleritis
Causes:
- Allergic reactions
- Infections
- Irritation
Clinical Features:
- Redness and swelling of the conjunctiva
- Pain on movement of the eye
- Discharge
Investigations:
- Slit lamp examination
- Biopsy
Complications:
- Uveitis
- Glaucoma
Management:
- Topical corticosteroids
- Oral corticosteroids
- Antibiotics
- Pain relief

Scleritis

Scleritis is inflammation of the sclera.
Types:
- Anterior scleritis
- Posterior scleritis
Causes:
- Infections
- Autoimmune disorders
- Trauma
Clinical Features:
- Pain on movement of the eye
- Redness and swelling of the conjunctiva
- Vision disturbances
Investigations:
- Slit lamp examination
- Imaging studies (CT or MRI)
Complications:
- Uveitis
- Glaucoma
- Scleral thinning
Management:
- Topical corticosteroids
- Oral corticosteroids
- Immunomodulators
- Pain relief

Management of Scleral Diseases

Homoeopathic Management of Scleral Diseases