Classification of Scleritis
Scleral inflammation is classified based on the site (anterior vs posterior), severity (necrotizing vs nonnecrotizing), and pattern of scleral inflammation (diffuse vs nodular). This classification system is useful in the clinical setting, helping to predict the clinical course, systemic disease association, treatment, and prognosis (Table 7-1). An underlying inflammatory systemic disorder can be identified in nearly 40% of individuals with scleritis. In those with necrotizing scleritis, this association rises to up to 50%–60%.
Although infrequent, the onset of features of necrotizing scleritis in a case of initially nonnecrotizing disease can occur in up to 15% of cases, prompting further investigation and adequate therapy.
Table 7-1 Classification of Scleritis
Similar to uveitis, scleritis can also be classified as noninfectious or infectious. The latter is frequently associated with surgery or trauma. This distinction is critical since aggressive inadvertent use of corticosteroids or immunomodulatory therapy in cases of an underlying infectious etiology can lead to devastating consequences.
Excerpted from BCSC 2020-2021 series: Section 9 - Uveitis and Ocular Inflammation. For more information and to purchase the entire series, please visit https://www.aao.org/bcsc.