Dr Kola Tytler MBBS CertHE MBA MRCGPClinical Lead • iatroX
A patient presenting with scleritis should be considered for underlying systemic conditions, as scleritis is frequently associated with systemic autoimmune or inflammatory diseases NICE CKS Smith et al. 2007. Approximately half of all scleritis cases are linked to an underlying systemic disease Smith et al. 2007.
- Rheumatoid arthritis is a common systemic condition associated with scleritis NICE NG100 Smith et al. 2007.
- Other connective tissue diseases such as Systemic Lupus Erythematosus (SLE) should be considered Sin et al. 2016.
- Vasculitides are important to investigate, particularly Granulomatosis with Polyangiitis (formerly Wegener's granulomatosis), which can cause severe ocular and systemic disease Tarabishy et al. 2010. Other vasculitides like Polyarteritis Nodosa may also be linked Smith et al. 2007.
- Spondyloarthropathies, such as ankylosing spondylitis and psoriatic arthritis, are also associated with inflammatory eye conditions NICE NG65.
- Other conditions that may be considered include inflammatory bowel disease (Crohn's disease, ulcerative colitis) and sarcoidosis Smith et al. 2007.
- Raynaud's phenomenon, while a symptom, can be indicative of underlying connective tissue diseases that are associated with scleritis NICE CKS.
Key References
- CKS - Uveitis
- CKS - Raynaud's phenomenon
- CKS - Leg ulcer - venous
- NG65 - Spondyloarthritis in over 16s: diagnosis and management
- NG100 - Rheumatoid arthritis in adults: management
- (Smith et al., 2007): Therapy insight: scleritis and its relationship to systemic autoimmune disease.
- (Tarabishy et al., 2010): Wegener's granulomatosis: clinical manifestations, differential diagnosis, and management of ocular and systemic disease.
- (Sin et al., 2016): Nodular Posterior Scleritis Mimicking Choroidal Tumor in a Patient With Systemic Lupus Erythematous: A Case Report and Literature Review.