For a patient with suspected scleritis, initial investigations are primarily conducted by an ophthalmologist following an urgent referral from primary care NICE CKS,NICE NG65. Scleritis is a serious inflammatory eye condition, and similar to uveitis, its diagnosis requires specialist assessment NICE CKS.
In primary care, the recommended action is to refer the patient for an immediate (same-day) or urgent (within 24 hours) ophthalmological assessment NICE CKS,NICE NG65. This urgent referral is necessary because conditions like uveitis cannot be definitively diagnosed without a slit-lamp examination, which is typically not available in primary care settings NICE CKS. During the specialist assessment, a slit-lamp examination with dilated pupils and measurement of intraocular pressure are crucial for confirming the diagnosis NICE CKS. It is important that primary care does not initiate treatment for such conditions unless specifically advised by an ophthalmologist NICE CKS.