Corneal sensation in scleritis and episcleritis

A series of 59 patients were examined for loss of corneal sensitivity. Thirty-five of them suffered from scleritis and 24 suffered from episcleritis. There was a difference between the 2 conditions in that significantly more patients with scleritis were affected than patients with episcleritis. It was also found that among the scleritis patients there was a close relationship between the number of quadrants affected and decrease in sensitivity. Five patients had necrotising scleritis, and they all showed marked loss of sensitivity. Sensitivity returned to normal when the scleritis resolved except when a large area of scleral ectasia resulted. The test is of importance because it is one of the easiest methods of detecting the onset of necrotising scleritis in its earliest stages.