Current concepts in the management of scleritis

Scleritis is an important, severely destructive, chronic inflammatory disorder affecting the eye wall. It presents a difficult management problem, often requiring high-dose systemic corticosteroid therapy or other immunosuppressive regimens to control the inflammatory response. A quantitative scleritis scoring system has been developed and its application to the assessment and management of scleral disease is discussed. This paper reviews current concepts in the management of scleral disease with emphasis on newer treatment modalities, such as pulse therapy with intravenously administered methylprednisolone or cyclophosphamide, and the use of orally administered cyclosporin.