Dhyan Selvaraj

Abstract

Background: Episcleritis and scleritis are both inflammatory disorders of the eye and may have underlying systemic disorder precipitating them. Therefore a thorough clinical examination and laboratory investigations are needed to rule them out. Systemic conditions that have been associated include rheumatoid arthritis, Wegener’s granulomatosis, systemic vasculitis, systemic lupus erythematosis, sarcoidosis, spondyloarthropathies, tuberculosis, gout, syphilis, hepatitis B and many others. Aim: To estimate the prevalence of systemic disorders in patients with episcleritis and scleritis visiting ophthalmology OPD. To identify the potential underlying systemic disorders requiring treatment. Results: This study was conducted in 105 patients who attended ophthalmology outpatient department of a tertiary care hospital over a period of one year and four months. Systemic association of a precipitating disease was noted in 20% of cases and the remaining 80% of cases had no association of an underlying precipitating systemic illness. Tuberculosis was a major precipitating disorder associated with scleritis and episcleritis. Rheumatoid arthritis, systemic lupus erythematosis, Wegener granulomatosis, syphilis, inflammatory bowel disease, sarcoidosis, ankylosing spondylitis and herpes zoster were some of the other systemic associations noted. Conclusion: Scleritis and episcleritis are common conditions encountered in an ophthalmology out patient department. Their frequent association with an underlying systemic disorder prompts us to assess the systemic status of such patients. Early diagnosis and proper management of such disorders has helped to reduce both systemic and ocular morbidity.   Keywords: Scleritis, Episcleritis, Ocular features of systemic diseases.

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