At a glance - Scleritis versus uveitis

SCLERITIS

Discriminatory signs
- Very painful deep, boring ache.
- Tender eye.
- Bluish purple discolouration of the sclera.
- Watering of the eye and photosensitivity.
- More common in women aged 30s-50s.
- Can affect both eyes.
- Can accompany autoimmune disorders.
- About half of cases have no known cause.

Management
- Refer.
- NSAIDs or prednisone.
- Patients with rheumatoid arthritis or those unresponsive to
corticosteroids may need cyclophosphamide or azathioprine.

UVEITIS
Discriminatory signs
- In most people no cause is identified.
- Can involve both eyes.
- Sudden onset of severe pain in the eye.
- Circumcorneal congestion.
- Photophobia.
- Blurred vision.
- Meiotic pupil.
- Many have only one episode of uveitis.

Management
- Refer to ophthalmologist.
- Corticosteroids. Mydriatic scopolamine, cyclopentolate or atropine eye
drops.

- Contributed by Dr Vasa Gnanapragasam, GP in Sutton, Surrey.

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