At the time of onset, the scleral surface and bulbar conjunctiva at the lesion site showed fan-shaped localization or diffuse congestion and edema, with a dark red appearance. The disease can relapse many times, and women are more likely to have attacks during their menstrual period.

Diagnosis and differential diagnosis: Conjunctivitis is diffuse and hyperemic, often accompanied by secretions, while scleritis is mostly limited to the limbus to the cornea. In the area of ​​muscle attachment point, the palpebral conjunctiva is not involved, and the hyperemic blood vessels radiate vertically from the cornea. The edge extends backward. Episcleritis hyperemia and edema are limited to the surface layer of the sclera and do not involve other The sclera underneath can be clearly identified through the slit light beam, and the blood vessels shrink rapidly after epinephrine is dripped. Shrinkage turns white; scleritis congestion turns purple. Does not fade after epinephrine drops.

① Anterior scleritis lesions are located in front of the equator, and the disease occurs in both eyes one after another. Eye pain, tenderness, and irritation symptoms, some The patient's pain was more obvious at night. ②Due to the expansion of the deep scleral vascular network, the lesion may have a purple appearance. The scleral surface and sclera are visible under the slit lamp They all had edema. ③ This disease can still be complicated by uveitis, keratitis, and cataracts, and secondary glaucoma can be formed due to angle adhesion.

1. Diffuse anterior scleritis: The sclera is diffusely hyperemic and the bulbar conjunctiva is edematous. Inflammation may involve one quadrant or the entire anterior sclera.

2. Nodular anterior scleritis: The local sclera is purple-red and congested, and the inflammatory infiltration and swelling form nodular protrusions and nodules. Hard, tender, unable to push.

3. Necrotizing anterior scleritis

Posterior scleritis is an inflammatory disease that occurs behind the equator and around the sclera and optic nerve.

Clinical manifestations: Clinically, it often manifests as eye pain and tenderness of any degree, vision loss, and may also present as headache. Sometimes the eye pain and headache are severe, and even accompanied by a sense of fear. Eyelids and bulbar conjunctiva edema, congestion is not obvious Or there is no congestion, and the eyeball may be slightly protruding. Involvement of extraocular muscles may cause limitation of eyeball movement and diplopia. compare Common fundus changes include chorioretinal folds and streaks, optic disc and macular edema, localized Uplift etc.

Treatment: ① Treatment of the cause ② Anti-inflammatory treatment: Topical instillation of glucocorticoids can reduce the inflammatory reactions of nodular or diffuse anterior scleritis. If local drops alone cannot control inflammation, non-steroidal anti-inflammatory drugs can be used according to the condition. medicine. For severe cases, adequate local and systemic glucocorticoids should be used, but caution should be used With peribulbar injection, especially in patients with necrotizing scleritis, peribulbar injection may cause scleral Membrane perforation. If glucocorticoids are ineffective, immunosuppressive therapy may be considered. like If the sclera shows signs of necrosis, combined medication may be considered. ④ Scleral reinforcement can be tried on necrotic or perforated scleral areas. ⑤Treatment of complications. For example, if glaucoma is complicated by intraocular pressure, intraocular pressure should be lowered in time, and if iridocyclitis is complicated by iridocyclitis, Mydriasis treatment.