When arthritis manifests, it can cause inflammatory diseases such as scleritis. Likewise, immunomodulatory agents should be considered in those who might otherwise be on chronic steroid use. To prevent the spread of viral conjunctivitis, patients should be counseled to practice strict hand washing and avoid sharing personal items; food handlers and health care workers should not work until eye discharge ceases; and physicians should clean instruments after every use.13 Referral to an ophthalmologist is necessary if symptoms do not resolve after seven to 10 days or if there is corneal involvement.4 Topical corticosteroid therapy for any cause of red eye is used only under direct supervision of an ophthalmologist.5,12 Suspected ocular herpetic infection also warrants immediate ophthalmology referral. It can occasionally be a little more painful than this and can cause inflamed bumps to form on the surface of the eye. Jabs DA, Mudun A, Dunn JP, et al; Episcleritis and scleritis: clinical features and treatment results. Benefits of antibiotic treatment include quicker recovery, early return to work or school, prevention of further complications, and decreased future physician visits.2,6,16. Medications that fit into this category, such as prednisone, are specifically designed to reduce inflammation. For the most part, however, episcleritis treatments address the underlying inflammatory conditions. All rights reserved. The University of Iowa. If the patient is taking warfarin (Coumadin), the International Normalized Ratio should be checked. Patient is a UK registered trade mark. America Journal of Ophthalmology. It is typically much more severe than the discomfort of episcleritis. Seasonal allergic conjunctivitis is the most common form of the condition, and symptoms are related to season-specific aeroallergens. Scleritis is less common, affecting only about 4 people per 100,000 per year. Scleral translucency following recurrent scleritis. A severe pain that may involve the eye and orbit is usually present. (October 1998). Red-free light with the slit lamp also accentuates the visibility of the blood vessels and areas of capillary nonperfusion. A typical starting dose may be 1mg/kg/day of prednisone. Even if your symptoms improve, it's important to follow up with an ophthalmologist on a . Polymerase chain reaction testing of conjunctival scrapings is diagnostic, but is not usually needed. If the infection does not improve within one week of treatment, the patient should be referred to an ophthalmologist.4,5. How can I make a broken blood vessel in my eye heal faster? What could this be? Both cause redness, but scleritis is much more serious (and rarer) than episcleritis. Doctors predominantly prescribe them to their patients who are living with arthritis. Episcleritis and scleritis are inflammatory conditions. An eye doctor can give or prescribe lubricating eye drops to soothe the irritation and redness. Find more COVID-19 testing locations on Maryland.gov. Episcleritis and scleritis are inflammatory conditions which affect the eye. Survey of Ophthalmology 2005. artificial tear eye drops nonsteroidal anti-inflammatory drugs, such as ibuprofen (Advil, Motrin) treating an underlying inflammatory condition Home remedies While you wait for your. It also can help with eye pain and may help protect your vision. In the anterior segment there may be associated keratitis with corneal infiltrates or thinning, uveitis, and trabeculitis. . (November 2021). Okhravi et al. Keep in mind that despite treatment, scleritis may come back. Scleritis is a painful, destructive, and potentially blinding disorder that may also involve the cornea, adjacent episclera, and underlying uveal tract. Posterior scleritisis the more rare form of the disease, and occurs at the back of the eye. Try our Symptom Checker Got any other symptoms? may be normal. rheumatoid arthritis) or other disease process. Anterior scleritis, is more common than posterior scleritis. Simple annoyance or the sign of a problem? It is also slightly more common in women. What is the long-term outlook (prognosis) for episcleritis and scleritis? If the eye is very uncomfortable, episcleritis may be treated with, If this isn't enough (more likely in the nodular type). Reproduction in whole or in part without permission is prohibited. The non-necrotising forms of scleritis do not usually permanently affect vision unless the patient goes on to develop. Conjunctivitis causes itching and burning but is not associated with pain. Surgery may be needed in severe cases to repair eye damage and prevent vision loss. The onset of scleritis is gradual. It also thins the sclera, consequently exposing the inner structure of the eye. Chronic pain can be debilitating if not treated. Other symptoms include: Scleritis at times arises without an identifiable cause. This can be superficial or deep, localized or diffuse, anterior or posterior. 2005 - 2023 WebMD LLC. If the eye is very uncomfortable, episcleritis may be treated with non-steroidal anti-inflammatory drugs (NSAIDs) in the form of eye drops. Treatment for Scleritis Scleritis is best managed by treating the underlying cause. 2012 Dec;88(1046):713-8. The primary goal of treatment of scleritis is to minimize inflammation and thus reduce damage to ocular structures. Treatments can restore lost vision and prevent further vision loss. Cataracts Its rare, but if the sclera is torn or in danger of tearing, surgery may be needed to reinforce it. Most of the time, though,. The information on this page is written and peer reviewed by qualified clinicians. Treatment. It is usually self-limiting (lasting up to three weeks) and is diagnosed clinically. What you can do: In some cases, corticosteroid eye drops can control inflammation, but often the problem is too deep within the eye to be controlled locally. It can be categorized as anterior with diffuse, nodular, or necrotizing subtypes and posterior with diffuse or nodular subtypes. People who are most susceptible to scleritis are those who have an autoimmune disease such as arthritis. Causes Scleritis is often linked to autoimmune diseases. Management of scleritis involves ophthalmology consultation and steroids . Worsening of the pain during eye movement is due to the extraocular muscle insertions into the sclera. Theyll look closely at the inside and outside of your eye with a special lamp that shines a beam of light into your eye. If other treatments don't work, your doctor might suggest surgery to put a small device called an implant into . How do you treat scleritis and how long does it take to resolve? For details see our conditions. In infective scleritis, if infective agent is identified, topical or . The diffuse type tends to be less painful than the nodular type. American Academy of Ophthalmology. Laboratory tests include complete blood count (CBC) with differential, erythrocye sedimentation rate (ESR) or C-reactive protein (CRP), serum autoantibody screen (including antinuclear antibodies, anti-DNA antibodies, rheumatoid factor, antineutrophil cytoplasmic antibodies), urinalysis, syphilis serology, serum uric acid and sarcoidosis screen. This form can cause problems resulting inretinal detachment and angle-closure glaucoma. 50(4): 351-363. . You may have scleritis in one or both eyes. These superficial vessels blanch with 2.5-10% phenylephrine while deeper vessels are unaffected. It may involve one or both eyes and is often associated with other inflammatory conditions such as rheumatoid arthritis. Patient aims to help the world proactively manage its healthcare, supplying evidence-based information on a wide range of medical and health topics to patients and health professionals. Uveitis is an inflammation of the uvea, the middle part of the eye, which lies just behind the sclera. Copyright 2023 Jobson Medical Information LLC unless otherwise noted. Among the suggested treatments are topical steroids, oral NSAIDs and corticosteroids. Journal of Clinical Medicine. HOLLY CRONAU, MD, RAMANA REDDY KANKANALA, MD, AND THOMAS MAUGER, MD. Complications are frequent and include peripheral keratitis, uveitis, cataract and glaucoma. The eye examination should include the eyelids, lacrimal sac, pupil size and reaction to light, corneal involvement, and the pattern and location of hyperemia. A similar condition called episcleritis is much more common and usually milder. There are two categories of scleritis: posterior scleritis and anterior scleritis. Rarely, it is caused by a fungus or a parasite. Canadian Family Physician. Episodes may be recurrent. Conjunctivitis is the most common cause of red eye. Vitamin A Vitamin A contains antioxidant compounds that are important in promoting healthy vision by reducing inflammation. Smart Grocery Shopping When You Have Diabetes, Surprising Things You Didn't Know About Dogs and Cats, Smoking Pot Every Day Linked to Heart Risks, Artificial Sweetener Linked to Heart Risks, FDA Authorizes First At-Home Test for COVID and Flu, New Book: Take Control of Your Heart Disease Risk, MINOCA: The Heart Attack You Didnt See Coming, Health News and Information, Delivered to Your Inbox. Posterior scleritis is also associated with systemic disease and has a high likelihood of causing visual loss. If artificial tears cause itching or irritation, it may be necessary to switch to a preservative-free form or an alternative preparation. These diseases occur when the body's immune system attacks and destroys healthy body tissue by mistake. The most severe can be very painful and destroy the sclera. An eye doctor who sees these conditions frequently can tell them apart. Scleritis associated with autoimmune disease is characterized by zonal necrosis of the sclera surrounded by granulomatous inflammation and vasculitis. America Journal of Ophthalmology. Masks are required inside all of our care facilities. Berchicci L, Miserocchi E, Di Nicola M, et al; Clinical features of patients with episcleritis and scleritis in an Italian tertiary care referral center. National Eye Institute. People with this type of scleritis may have pain and tenderness. As scleritis is associated with systemic autoimmune diseases, it is more common in women. Scleritis can lead to permanent damage to the structure of the eye, including: Episcleritis does not usually have any significant long-term consequences unless it is associated with an underlying disease such as rheumatoid arthritis. Using corticosteroid eye drops may help ease the symptoms faster. 2,500 to 5,000 (monthly). A 66-year-old female visited another eye clinic and was diagnosed as . So, its vitally important to get to the bottom of this uncommon but aggravating condition. Severe vasculitis as well as infarction and necrosis with exposure of the choroid may result. The management will depend on what type of scleritis this is and on its severity. They can initially look similar but they do not feel similar and they do not behave similarly. Episcleritis is the inflammation of the outer layer of the sclera. Treatment depends on the cause of the scleritis, and may sometimes be long-term involving steroids or other immune-modulating medicines. When episcleritis is suspected, an ophthalmologist will examine the patient with a slit lamp. The nodules may be single or multiple in appearance and are often tender to palpation. Chronic bacterial conjunctivitis is characterized by signs and symptoms that persist for at least four weeks with frequent relapses.2 Patients with chronic bacterial conjunctivitis should be referred to an ophthalmologist. The diagram shows the eye including the sclera. Sometimes there is no known cause. Certain conditions increase the risk of uveitis, but the disease often occurs for no known reason. Consultation with a rheumatologist or other internist is recommended. How should my husband treat psoriasis of his eyelids? 2013 Jan6(1):65-6. doi: 10.4103/0974-620X.111938. Treatment depends on the cause of the scleritis, and may sometimes be long-term involving steroids or other immune-modulating medicines. If the problem is severe, a steroid medicine may help. Tear osmolarity is the best single diagnostic test for dry eye.30,31 The overall accuracy of the diagnosis increases when tear osmolarity is combined with assessment of tear turnover rate and evaporation. By Michael Trottini, OD, and Candice Tolud, OD. Clinical examination is usually sufficient for diagnosis. Microabscesses may be found in addition to necrotizing inflammation in infectious scleritis. More Than Meets the Eye: A Rare Case of Posterior Scleritis Masquerading as Orbital Cellulitis. Mild cases of keratopathy usually clear up with eye drops or medicated eye ointment. There also can be pain of the jaw, face, or head. Postoperative Necrotizing Scleritis: A Report of Four Cases. Evaluation of Patients with Scleritis for Systemic Disease. We report here a case of bilateral posterior scleritis with acute eye pain and intraocular hypertension, initially misdiagnosed as acute primary angel closure. More recently, tumor necrosis factor (TNF) alpha inhibitors such as infliximab have shown promise in the treatment of non-infectious scleritis refractory to other treatment. Scleritis causes eye redness accompanied by a lot of pain. With posterior scleritis, you cant usually see these kinds of issues because theyre on the back of the white of your eye. Certain types of uveitis can return after treatment. Your email address will only be used to answer your question unless you are an Academy member or are subscribed to Academy newsletters. and omeprazole (20 mg/d) to counter the side effects of steroid treatment. (November 2021). Scleritis needs to be treated as soon as you notice symptoms to save your vision. Examination in natural light is useful in differentiating the subtle color differences between scleritis and episcleritis. 10,000 to Rs. Patients with renal compromise must be warned of renal toxicity. The sclera is notably white, avascular and thin. Posterior scleritis is defined as involvement of the sclera posterior to the insertion of the rectus muscles. It may involve the cornea, adjacent episclera and the uvea and thus can be vision-threatening. The condition also typically affects women more than men. You may need additional eye therapy when using these as they are less effective when used on their own. Episcleritis is a fairly common condition. Uveitis. Scleritis and episcleritis ICD9 379.0 (excludes syphilitic episcleritis 095.0). This underlying disease causes many of the symptoms of scleritis. All rights reserved. If this isn't enough (more likely in the nodular type) steroid eye drops are sometimes used, although only under the care of an eye specialist (ophthalmologist). (October 2010). (October 2017). The non-necrotising types are usually treated with. TNF-alpha inhibitors may also result in a drug-induced lupus-like syndrome as well as increased risk of lymphoproliferative disease. A more recent article on evaluation of painful eye is available. . All rights reserved. Scleritis Scleritis The sclera is the white outer wall of the eye. A branching pattern of staining suggests HSV infection or a healing abrasion. A more recent article on evaluation of painful eye is available, Features and Serotypes of Chlamydial Conjunctivitis. Episcleritis is usually idiopathic and non-vision threatening without involvement of adjacent tissues. There are additional images of types of scleritis in Further Reading below. In episcleritis, hyperemia, edema and infiltration of the superficial tissue is noted along with dilated and congested vascular networks. Posterior inflammation is usually not visible on exam, and the ophthalmologist can use ultrasound, looking for signs of inflammation behind the eye. Anterior scleritis also may make the white of your eye look red, and you may see small bumps there. Scleritis and episcleritis. Some of the new 'biological agents' such as rituximab can also be effective. Both choroidal exposure and staphyloma formation may occur. Surgical biopsy of the sclera should be avoided in active disease, though if absolutely necessary, the surgeon should be prepared to bolster the affeted tissue with either fresh or banked tissue (i.e., preserved pericardium, banked sclera or fascia lata). Scleritis Version 10 Date of search 12.09.21 Date of revision 25.11.21 Date of publication 07.04.22 It is widespread inflammation of the sclera covering the front part of the eye. International Society of Refractive Surgery, lupus, or other connective tissue disease, redness and swelling of the white part of the eye, look at the inside and outside of your eye using a, corticosteroid pills (medicine to control inflammation), nonsteroidal anti-inflammatory drugs (NSAIDs) like aspirin or ibuprofen for pain and, drugs that weaken or modify the response of the immune system may be used with severe scleritis (immunosuppressive and immunomodulatory drugs). Its important to see your ophthalmologist and other doctors regularly for the most effective treatment. . The episclera lies between the sclera and the conjunctiva. Episcleritis is most common in adults in their 40s and 50s. How do you treat a wasp sting on the eyelid? Other conditions linked to scleritis include: Other causes can include eye trauma and in very rare cases fungal or parasite infections. Treatment includes supportive care, cycloplegics (atropine, cyclopentolate [Cyclogyl], homatropine, scopolamine, and tropicamide), and pain control (topical nonsteroidal anti-inflammatory drugs [NSAIDs] or oral analgesics). Our clinical information meets the standards set by the NHS in their Standard for Creating Health Content guidance. If symptoms are mild it will generally settle by itself. Scleritis: Scleritis needs treatment with non-steroid anti-inflammatory drugs and steroids. Scleromalacia perforans does not respond well to treatment - research continues to find the best way to manage this rare condition. Azithromycin eye drops may also be used in the treatment of blepharitis. In severe cases, prolonged use of oral antibiotics (doxycycline or tetracycline) may be beneficial.33 Topical steroids may also be useful for severe cases.30. This regimen should continue indefinitely. Generally, viral and bacterial conjunctivitis are self-limiting conditions, and serious complications are rare. Another type causes tender nodules (bumps) to appear on the sclera, and the most severe can be very painful and destroy the sclera. The white part of the eye (sclera) swells and reddens. ByAsagan (own work), CC BY-SA 3.0, via Wikimedia Commons. Scleritis is a serious inflammatory disease that . There may be cell-mediated immune response as there is increased HLA-DR expression as well as increased IL-2 receptor expression on the T-cells. It may be worse at night and awakens the patient while sleeping. Chapter 4.11: Episleritis and Scleritis. Patients with necrotizing scleritis have a high incidence of visual loss and an increased mortality rate. Non-steroidal anti-inflammatory drugs are the standard regimen doctors use to get rid of both types of scleritis. . Instruction Courses and Skills Transfer Labs, Program Participant and Faculty Guidelines, LEO Continuing Education Recognition Award, What Practices Are Saying About the Registry, Provider Enrollment, Chain and Ownership System (PECOS), Subspecialty/Specialized Interest Society Directory, Subspecialty/Specialized Interest Society Meetings, Minority Ophthalmology Mentoring Campaign, Global Programs and Resources for National Societies. It is slightly more common in women than in men, and in people who have connective disease disease such as rheumatoid arthritis. We are vaccinating all eligible patients. Anterior: This is when the front of your sclera is inflamed. Another, more effective, option is a second-generation topical histamine H1 receptor antagonist.15 Table 4 presents ophthalmic therapies for allergic conjunctivitis. Scleritis is often associated with an underlying systemic disease in up to 50% of patients. Scleritis may affect either one or both eyes. WebMD does not provide medical advice, diagnosis or treatment. Inflammation has caused the ciliary body to rotate, creating anterior displacement of the lens iris diaphragm. However, we will follow up with suggested ways to find appropriate information related to your question. Studies comparing the effectiveness of different ophthalmic antibiotics did not show one to be superior.2326 The choice of antibiotic (Table 3) should be based on cost-effectiveness and local bacterial resistance patterns. T-cells and macrophages tend to infiltrate the deep episcleral tissue with clusters of B-cells in perivascular areas. https://eyewiki.org/w/index.php?title=Scleritis&oldid=84980. Finally, the conjunctival and superficial vessels may blanch with 2.5-10% phenylephrine but deep vessels are not affected. There is often a zonal granulomatous reaction that may be localized or diffuse. Up to 50 percent of patients with scleritis have an underlying systemic illness, most often a rheumatic disease. Scleritis: a clinicopathologic study of 55 cases. Patients who have had multiple eye surgeries are also at high risk of getting scleritis. Treatment involves eyelid hygiene (cleansing with a mild soap, such as diluted baby shampoo, or eye scrub solution), gentle lid massage, and warm compresses. Scleritis presents with a characteristic violet-bluish hue with scleral edema and dilatation. Arthritis with skin nodules, pericarditis, and anemia are features of rheumatoid arthritis. Pain is nearly always present and typically is severe and accompanied by tenderness of the eye to touch. In general, scleritis is more common in women than men and usually occurs during the fifth decade of life [2]. Most patients develop severe boring or piercing eye pain over several days. Some people only have one type of scleritis, but others can have inflammation at the front and back of the eye. Implants. Sclerosing keratitis may present with crystalline deposits in the posterior corneal lamellae. Red eye is the cardinal sign of ocular inflammation. Non-selective COX-inhibitors such as flurbiprofen, indomethacin and ibuprofen may be used. Episcleritis does not usually lead to any complications: your eyesight shouldn't be affected at all. Episcleritis is a localized area of inflammation involving superficial layers of episclera. As mentioned earlier, the autoimmune connective tissue diseases of rheumatoid arthritis, lupus, sero-negative spondylarthropathies and vasculitides such as granulomatosis with polyangiitis and polyarteritis nodosa are most frequently seen. If your sclera grows inflamed or sore, visit your eye doctor immediately. Your eye doctor may be able to detect scleritis during an exam with a slit lamp microscope. Diffuse anterior scleritis is the most common type of anterior scleritis. Fluorescein staining under a cobalt blue filter or Wood lamp is confirmatory. Treatment Episcleritis often requires no treatment but in some cases a course of steroid eye drops is required. Scleritis is usually not contagious. Investigation of underlying causes is needed only for recurrent episodes and for symptoms suggestive of associated systemic diseases, such as rheumatoid arthritis. Case 2. Treatment includes frequent applications of artificial tears throughout the day and nightly application of lubricant ointments, which reduce the rate of tear evaporation. Registered in England and Wales. Journal Francais dophtalmologie. Because its usually related to autoimmune disorders, your doctor may suggest that you see a rheumatologist (a doctor who specializes in autoimmune conditions). A lot of people might have it and never see a doctor about it. Patients with chronic blepharitis who do not respond adequately to eyelid hygiene and topical antibiotics may benefit from an oral tetracycline or doxycycline. Another type causes tender nodules (bumps) to appear on the sclera. At-Home Treatment Because episcleritis is mild, you can treat it at home by: Using a cold compress over closed eyes Using refrigerated artificial tear eye drops Protecting your eyes from strong outdoor light (sunglasses) Episcleritis vs. Scleritis If the disease is inadequately controlled on corticosteroids, immunomodulatory therapy may be necessary. There isnt always an obvious reason it happens, but most of the time, its caused by an autoimmune disorder (when your bodys defense system attacks its own tissues). Epub 2013 Nov 12. Scleritis presents with a characteristic violet-bluish hue with scleral edema and dilatation. Scleritis is usually an indication that inflammation is out of control, not only in the eye but elsewhere in the body, so keeping your arthritis under control is critical. If you develop scleritis you should be urgently referred to an eye specialist (ophthalmologist). Adjustment of medications and dosages is based on the level of clinical response. The cost of treatment depends on the type of inflammation and also the type of scleritis. Scleritis is the inflammation in the episcleral and scleral tissues with injection in both superficial and deep episcleral vessels. Necrotizing anterior sclerosis is the rarest of the three types and one of the most severe. Treatment consists of repeated infusions as the treatment effect is short-lived. You may need an additional visit with a primary care doctor or rheumatologist to perform blood tests or X-rays to uncover a related underlying medical condition. Uveitis has many of the same symptoms as scleritis, including redness and blurry vision, but it has many subtle differences. Treatment focuses on reducing the inflammation. The condition is usually benign and can be managed by primary care physicians. Contents 1 1.1 Disease Treatment involves supportive care and use of artificial tears. It is often associated with an upper respiratory infection spread through coughing. Two or more surgical procedures may be associated with the onset of surgically induced scleritis. Pharmacotherapy of Scleritis: Current Paradigms and Future Directions. Patient information: See related handout on pink eye, written by the authors of this article. Scleritis is often associated with an underlying systemic disease in up to 50% of patients. A thorough patient history and eye examination may provide clues to the etiology of red eye (Figure 1). For people with systemic inflammatory diseases such as rheumatoid arthritis, good control of the underlying disease is the best way of preventing this complication from arising. Hyperemia and pain were scored before each treatment, at 1 and 2 weeks, and at 1 month after initiation of each treatment using 5 grades (0=none; 1+=mild; 2+=moderate; 3+=severe; 4+=extremely severe). eCollection 2015. A similar patient who presented with nodular, non-necrotizing scleritis. Am J Ophthalmol. Treatments for scleritis may include: Corticosteroid eye drops to help reduce the inflammation Corticosteroid pills Newer, nonsteroid anti-inflammatory drugs (NSAIDs) in some cases Certain anticancer drugs (immune-suppressants) to help reduce the inflammation in severe cases Epistaxis, sinusitis and hemoptysis are present in granulomatosis with polyangiitis (formerly known as Wegener's). Case 3. It causes blindness if it is not managed and treated early. The sclera is the . Both forms of episcleritis cause mild discomfort in the eye. The primary goal of treatment of scleritis is to minimize inflammation and thus reduce damage to ocular structures. For very mild cases of scleritis, an over-the-counter non-steroidal anti-inflammatory drug (NSAID) like ibuprofen may be enough to ease your eye inflammation and pain. In patients with corneal abrasion, it is good practice to check for a retained foreign body under the upper eyelid. If you have symptoms of scleritis, you should see anophthalmologist as soon as possible. In addition to scleritis, myalgias, weight loss, fever, purpura, nephropathy and hypertension may be signs of polyarteritis nodosa. The history should include questions about unilateral or bilateral eye involvement, duration of symptoms, type and amount of discharge, visual changes, severity of pain, photophobia, previous treatments, presence of allergies or systemic disease, and the use of contact lenses. . They cannot be moved with a cotton-tipped applicator, which differentiates inflamed scleral vessels from more superficial episcleral vessels. Ibuprofen and indomethacin are often used initially for treating anterior diffuse and nodular scleritis. In nodular disease, a distinct nodule of scleral edema is present. Dry eye (keratoconjunctivitis sicca) is a common condition caused by decreased tear production or poor tear quality. Patients using oral NSAIDS should be warned of the side effects of gastrointestinal (GI) side effects including gastric bleeding. The membrane over my eyeball has started sliding around and has caused a wrinkle on my eyeball. Examples of steroid drops include prednisolone and dexamethasone eye drops. Statin Therapy Yields Higher Corneal Clarity, Point-Counterpoint: Ultra-Widefield Imaging vs. Dilated Funduscopy. Necrotising scleritis with inflammation is the most severe and distressing form of scleritis. However, vision is unaffected and painkillers are not generally needed. Mild allergic conjunctivitis may be treated with an over-the-counter antihistamine/vasoconstrictor agent, or with a more effective second-generation topical histamine H. Anti-inflammatory agents (e.g., topical cyclosporine [Restasis]), topical corticosteroids, and systemic omega-3 fatty acids are appropriate therapies for moderate dry eye. Ophthalmology 2004; 111: 501-506. Among the suggested treatments are topical steroids, oral NSAIDs and corticosteroids. Scleritis may be active for several months or years before going into long-term remission. Scleritis. Prescription eye drops are the most common treatment.
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