There are many possible causes of a red eye or eyes. Some are cause for concern; some are medical emergencies. Others are of no consequence or concern at all. The degree of redness or appearance of blood usually does not correlate to how serious the situation may be. It is generally more important whether you also have eye pain or impaired vision. Redness seen in the eyes can originate from dilated blood vessels in the top clear coating of the eye called conjunctiva or it can be from the deeper tissue called sclera.
The sclera is the hard, white outside coating that provides rigid structural support to the eye. The scleral tissue is closely related to connective tissues that provide support to joints. When the sclera becomes inflamed (red and swollen) it is called Scleritis. The suffix “itis” means inflammation.
Symptoms of scleritis include pain, redness, tearing, light sensitivity, and decreased vision. Pain is nearly always present and typically is severe and accompanied by tenderness of the eye to touch. The pain may be boring or piercing and often awakens patients from sleep. The significant pain of scleritis helps to differentiate it from other common causes of redness of the eyes, such as conjunctivitis. There is usually no discharge from the eye in scleritis however, a discoloration that is caused by the inflammation can have a bluish hue and can involve the entire white of the eye or be localized to only one area. The cause of scleritis is unknown in about half of all cases. It is more common in females and occurs most frequently in patients between the ages of 40-60 years. The mean age is 52. Because the sclera is made of connective tissue, other connective tissue disorders such as rheumatoid arthritis may cause scleritis. Other connective tissue disorders associated with scleritis include Lupus and Sarcoidosis. Scleritis may also occur in viral infections of the eye such as Herpes Zoster and Herpes Simplex. Inflammatory bowel disease or Crohn’s disease has also been associated with scleritis. Most patients with scleritis need to undergo a number of blood tests to determine if there is an underlying cause however, in many patients the disease appears to be localized to the eye and there is no disease elsewhere in the body.
The treatment for scleritis depends very much on how severe the inflammation presents. People with significant scleritis need treatment with oral steroids like prednisolone. Others, with more mild to moderate cases, can be successfully treated with oral non-steroidal antiinflammatory drugs like Naprosyn. Patients with mild disease may be able to get away with simply eye drops. The treatment will vary for each patient depending on how severe the disease is at the time. Unfortunately, even though scleritis can be treated, it cannot be cured.
Scleritis is a relapsing disease and even if someone recovers fully from an attack, it is quite possible that the scleritis will recur. One good thing about scleritis is that it is very uncommon for vision to be permanently affected. Even though vision may be blurred and the eye may be very painful during the episode, the usual course is for vision to return completely to normal and the pain to subside as the inflammation does.
If you have questions concerning scleritis, please contact our office in Stillwater at 405-372-1715. We also invite you to visit our website at www.cockrelleyecare.com and like us on Facebook at Cockrell Eye Care Center