Scleritis: The Daily PANCE Blueprint

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Scleritis: The Daily PANCE Blueprint

A 59-year-old female with a history of polyarteritis nodosa presents to your clinic complaining of bilateral eye pain and tenderness, as well as decreased vision, for the past few days. On physical exam, you notice conjunctival injection and a bluish hue to the eye. Which of the following is the most likely diagnosis?

A. Anterior uveitis
B. Scleritis
C. Conjunctivitis
D. Retinal detachment
E. Central retinal artery occlusion

Answer and topic summary

The answer is B. Scleritis

Scleritis is an immune-mediated inflammatory process of the sclera. Etiologies include rheumatoid arthritis, lupus, ankylosis spondylitis, polyarteritis nodosa, and granulomatosis with polyangiitis. Clinical features include an edematous sclera, globe tenderness/pain, decreased visual acuity, and congestion of the episcleral vessels. Often the eye will look bluish. It is a clinical diagnosis. Management includes oral NSAIDs, oral steroids, or immunosuppressants.

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Covered under ⇒ PANCE Blueprint EENT ⇒ Vision abnormalities (PEARLS) ⇒ Scleritis

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