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Scleritis and peripheral ulcerative keratitis.

Anat Galor¹, Jennifer E Thorne

¹Department of Ophthalmology, Wilmer Eye Institute, Johns Hopkins University, School of Medicine, 550 North Broadway, Suite 700, Baltimore, MD 21205, USA.

Rheumatic Diseases Clinics of North America

|November 27, 2007

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Scleritis and peripheral ulcerative keratitis (PUK) are serious eye conditions requiring prompt diagnosis. Most patients with non-infectious forms need systemic glucocorticoids, and some require additional immunosuppressants.

Area of Science:

Ophthalmology
Rheumatology
Immunology

Background:

Scleritis and peripheral ulcerative keratitis (PUK) are severe ocular conditions.
These conditions can be isolated or indicative of systemic disease.
Early diagnosis and treatment are crucial to prevent vision loss.

Purpose of the Study:

To review the management of non-infectious scleritis and PUK.
To emphasize the importance of identifying underlying systemic disorders.

Main Methods:

Review of clinical history and physical examination findings.
Discussion of laboratory evaluations for systemic disease.
Analysis of treatment strategies for non-infectious scleritis and PUK.

Main Results:

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Nearly two-thirds of patients with non-infectious scleritis require systemic glucocorticoids.
One-fourth of patients with non-infectious scleritis need glucocorticoid-sparing agents.
Essentially all patients with non-infectious PUK require systemic glucocorticoids.

Conclusions:

Systemic evaluation is essential for patients with scleritis and PUK.
Prompt and appropriate treatment, often involving systemic immunosuppression, is necessary to preserve vision.