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Scleral Disease

China Medical University NO.4


Affiliated hospital Ophthalmology;
Ophthalmology hospital of China
Medical University
Introduction

character
Outer wall of eye.
Collagen fiber & elastic fiber
Lack of cell and vessels
Less capacity of self repairingstaphyloma

Scleral Disease Commonly found in inflammation


disease course deferment medication inevident
Scleral Disease Classifications
Episcleritis
Scleritis
Episcleritis
Nodular episcleritis
acute in onset
symptoms:unilateral wine
round or ellipse limited nodular
uplift diameter 2 3mm
redness edema
irritation
Vission not affected
concurruent mild iritis
the inflammation subsided in 2 to
4 weeks easily recurrent
Episcleritis

Simple episcleritis
periodicity
redness and edema
light irritation,Vission not
affected
concurruent lid edema
disease course deferment
often found in Women's
menstrual period
self-limited
Episcleritis

different diagnoses
Episcleritis Conjunctivitis scleritis
Congestion Localized Diffused,
palpebral
conjunctiva
affected
Congestion Not affect sclera Affect
and edema sclera

Nodules movable unmovabl


e
Adrenaline Disappear Disappear Not
disappear
Episcleritis

Treatment
Self-limiting
Corticosteroids:
Eyedrop
ic
NSAIDs: po
Scleritis

Inflammation of sclera
Severe than episcleritis
Young and mid-age adults
Female>Male
Autoimmune disease
Complicated with general
collagenous,
granulomatous or metabolic
diseases.
Scleritis

pathogeny
Allergic reaction
Auto immune connective tissue diseases
Metabolic diseases
Other infection spreaded inflammation spreads in
the vicinity of the organization
Scleritis
anterior Scleritis:
disease site anterior equator bilateral eyes
current successively
clinical manifestations pain, Vision
decrease sclera focus
course long recurrent deferment
prognosis not good
complications Uveitis Keratitis Secondary
glaucoma e.g
Scleritis

Classification

diffuse anterior scleritis

nodular anterior scleritis

necrotizing anterior scleritis


diffuse anterior scleritis

about 40
prognosis preferably
sclera diffuse redness
bulbar conjunctiva
edema
diffuse anterior scleritis
nodular anterior scleritis

about 44
Scleral lesions dark red
inflammation Infiltrated
nodular Uplift hard
pain
concurruent Episcleritis
nodular anterior scleritis
necrotizing anterior scleritis

often Vision decrease about


14
pain Rapid development
occlusive vasculitis sclera
necrosis
areas of avascularity; lark nodula
perforated scleromalacia
perforans
often bilateral eyes
concurruent Serious
Autoimmune diseases
necrotizing anterior scleritis
Scleritis

Posterior Scleritis:
disease site Posterior equator about 2
clinical manifestations pain eyelid and bulbar
conjunctiva edema eyeball slightly Prominent
extraocular involved Concurruent Uveitis
Vitreous opacities e.g
diagnoses Examinations such as B-US CT
MRI,can show Posterior sclera thickening
different diagnoses Orbital cellulitis the
symptoms and exophthalmus are even Obvious
Scleritis

treatment
Pathogeny treatment
Symptomatic treatment coldly cover Artificial
tears
Anti-inflammatory treatment
corticosteroids Immunosuppressant e.g
Surgical treatment necrosic perforative Scleral site
can be done with Allogeneic scleral graft
Complications treatment glaucoma Iridocyclitis.
Sclera staphyloma

definition
Because of thinning of the sclera sclera
and deep uveal bulge and expand outward
with the function of intraocular pressure,and
revealed blue-black color of uveal color

Classification
anterior sclera staphyloma
equatorial sclera staphyloma
posterior sclera staphyloma
treatment
1. Decompression early

2. If the eyes have been


suffering from no light
perception And pain
eyes can be removed
Abnormal scleral color
Scleral pigment plaques brown or blue-
gray spots currented at anterior sclera surface and
entrance of Ciliary vessels Scleral melanosis
syndrome
Blue sclera It is caused by Uveal color
under sclera because of thin sclera concurruent
congenital anomalies
Sclera yellow Stained Jaundice
Brown macular:Brown-gray spots at
sclera which current at Palpebral fissure area
earliest
It can be distributed in the sclera, cornea and
conjunctiva No clinical significance