What are the first-line treatment options for managing scleritis in primary care?

First-line treatment options for managing scleritis are not initiated in primary care ²,³. Treatment with corticosteroid eye preparations, which may be used for inflammatory eye conditions, should always be initiated in secondary care by a specialist ². Primary care's role is limited to continuing and monitoring treatment only after a specialist management plan has been established ².

For suspected inflammatory eye conditions like uveitis, which shares similar management principles, primary care should not initiate treatment ³. This is because diagnosis requires a slit-lamp examination, which is not typically available in primary care ³. Initiating treatment without a confirmed diagnosis carries risks, such as worsening conditions like herpes simplex virus infections if corticosteroids are used inappropriately ²,³. People with eye pain and vision loss require immediate ophthalmology referral ³. Specialist referral is appropriate if symptoms persist, if other diagnoses need to be ruled out, or to prevent rare complications like sight-threatening keratitis ¹.