Eye Pain and Redness Caused by Scleritis

The sclera, the white part of the eye that forms the wall of the eyeball, is rich in collagen and connective tissue.

For this reason, inflammation involving collagen-containing tissue:
rheumatoid arthritis, ankylosing spondylitis, lupus

may be reflected in the eye as collagen disease:

When scleral inflammation is suspected, we also ask about
back pain, joint pain, and digestive symptoms

and similar signs.

Inflammation somewhere in the body is sometimes reflected in the eyes.

Eye Pain Caused by Scleritis

✔ Eye pain
✔ Eye discomfort
✔ Redness of the white of the eye
✔ Blurred vision
✔ Tearing
✔ Sensitivity to light

Symptoms such as eye pain and redness are sometimes caused by scleritis.

The pain of scleritis can be very severe:
It tends to worsen at night and can spread from the face to the jaw.

Why does scleritis cause eye pain?

The sclera is supplied by nerves from the cranial nerve → ciliary ganglion pathway,¹and the pain is thought to arise along with the inflammation.

・Anterior scleritis (inflammation at the front of the eyeball)
・Posterior scleritis (inflammation at the back of the eyeball)

Anterior scleritis is more common and is often seen in everyday practice.

Posterior scleritis may also be complicated by
・Retinal detachment²(affecting vision)
・Angle-closure glaucoma³(raising eye pressure).

These complications can occur.

Inflammation may also involve both the anterior and posterior sclera.

Nodular (lump-like) posterior scleritis is sometimes mistaken for choroidal malignant melanoma (an eye cancer),⁴。

and although very rare, it can be difficult to tell them apart.

Causes of scleritis

Scleritis is often associated with systemic or autoimmune disease.

○ Arthritis (joint swelling, stiffness, pain, etc.)⁵
○ Lupus (systemic lupus erythematosus, SLE)⁶ 
○ Inflammatory bowel disease: ulcerative colitis and Crohn’s disease ⁷
○ Sjögren’s syndrome ⁸
○ Ankylosing spondylitis ⁹　
○ Granulomatosis with polyangiitis ¹⁰ 
○ Scleroderma ¹¹ Other collagen diseases / connective tissue diseases
○ After an eye injury: fungal or parasitic scleritis ¹²　and others

Scleritis care

We examine the eye with a slit-lamp microscope, OCT, and enhanced-depth imaging OCT (EDI-OCT).
We ask about your general health, and may manage your care together with a rheumatology/collagen disease department.

Treatment ranges from steroid eye drops (Rinderon®^®, etc.) to cases that require surgery.

It may recur repeatedly.

After severe inflammation, the sclera can become thin (scleral thinning).

When it becomes very thin, the underlying uvea may show through:
In severe cases, the uvea can bulge out.

If that happens, serious visual impairment may remain.

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