[Scleritis and systemic diseases: What should know the internist?]

Area of Science:

• Ophthalmology
• Rheumatology
• Immunology

Background:

• Scleritis is an inflammatory condition affecting the eye's sclera.
• It frequently co-occurs with systemic diseases, notably rheumatoid arthritis, vasculitis, and spondyloarthropathies.
• Infectious causes, particularly herpetic infections, must be ruled out before diagnosing systemic etiology.

Purpose of the Study:

• To outline the clinical classification of scleritis.
• To highlight the association between scleritis and systemic autoimmune diseases.
• To emphasize the importance of differential diagnosis and collaborative management.

Main Methods:

• Clinical classification differentiating anterior and posterior scleritis.
• Review of associated systemic conditions.
• Emphasis on differential diagnosis, including infectious etiologies.
• Discussion of treatment strategies.

Main Results:

• Anterior scleritis can be diffuse or nodular with a generally good prognosis.
• Necrotizing scleritis, especially without inflammation, often indicates advanced rheumatoid arthritis.
• Scleritis is associated with systemic diseases in up to one-third of cases.

Conclusions:

• Scleritis classification is primarily clinical, distinguishing anterior and posterior forms.
• Association with systemic autoimmune diseases is common, necessitating thorough investigation.
• Effective management requires a collaborative approach between internists and ophthalmologists, utilizing therapies like corticosteroids, immunosuppressors, and biotherapies.