What is the Difference Between Uveitis and Scleritis

Uveitis and Scleritis are two types of conditions that affect the eye. In fact, both are due to the inflammation of the parts of the eye. Both these conditions may cause similar symptoms, such as eye pain and photophobia.

The key difference between uveitis and scleritis is the part of the eye they affect. Uveitis is caused by inflammation of the middle layer of the eye, which contains much of the eye’s blood vessels, while scleritis is a condition caused by inflammation of the sclera, which is the white part of the eye.

CONTENTS

1. Overview and Key Difference
2. What is Uveitis  
3. What is Scleritis
4. Similarities – Uveitis and Scleritis
5. Uveitis vs Scleritis in Tabular Form
6. Summary – Uveitis vs Scleritis
7. FAQ – Uveitis and Scleritis

What is Uveitis?

Uveitis is a condition that occurs when the middle layer of the eyeball gets inflamed. The symptoms of uveitis may include blurred vision, cloudy vision, floaters, general vision problems, eye pain, eye redness, photophobia, headaches, a small pupil, and alteration of the colour of the iris. Uveitis can be caused by infections such as shingles virus, herpes simplex virus, syphilis, Lyme disease, and parasitic diseases like toxoplasmosis,  inflammatory bowel disease (IBD), rheumatoid arthritis or lupus, and eye injury. The risk of getting uveitis may increase with smoking (cigarettes, cigars, or pipes).

Figure 01: Uveitis

Uveitis can be diagnosed through physical examination, blood or skin tests, eye fluid examination, and imaging tests, such as X-rays. Furthermore, treatment options for uveitis may include using pain control medications (NSAIDs), eye drops that contain inflammation-controlling medicines (corticosteroids), and antiviral medications that treat viruses and surgeries.

What is Scleritis?

Scleritis refers to the inflammation of the white part of the eye, known as sclera. It is mainly caused by autoimmune diseases such as rheumatoid arthritis, Crohn’s disease, and other vasculitis. However, it can also be caused by infections such as herpes infection, trauma to the eye, and medicines used to treat bone diseases. The symptoms of scleritis are redness and swelling of the sclera, pain and tenderness in the eye, watering eyes, and sensitivity to light, such as photophobia.

Figure 02: Scleritis

Scleritis can be diagnosed through eye examination (slit lamp examination), CT scan, ultrasound, and biopsy. Furthermore, treatment options for scleritis are taking intravenous corticosteroids to control inflammation, antibiotics, antivirals, antifungals, immunotherapeutic drugs like cyclophosphamide, methotrexate, mycophenolate mofetil, or biologic agents like rituximab, adalimumab, and scleral patching or grafts.

Similarities Between Uveitis and Scleritis

1. Uveitis and scleritis are two conditions caused by inflammation of the eye.
2. Both conditions may cause similar symptoms, such as vision problems, photophobia, etc.
3. Both conditions can be diagnosed through eye examination.
4. They can be treated with specific medications and surgeries.

Difference Between Uveitis and Scleritis

Definition

1. Uveitis is the inflammation of the middle layer of the eyeball.
2. Scleritis is the inflammation of the white part of the eye, known as sclera.

Causes

1. Uveitis is caused by autoimmune conditions like multiple sclerosis and ankylosing spondylitis,  herpes simplex virus infection, the herpes zoster virus (which causes shingles), toxoplasmosis, eye injury, and growth in the eye (neoplasia).
2. Scleritis is caused by eye infections, inflammatory bowel disease (IBD), sarcoidosis, lupus, Sjogren’s syndrome, vasculitis and scleroderma.

Symptoms

1. Symptoms of uveitis include eye pain, watery eyes, reduced or blurred vision, sensitivity to the light and lights in the corner of the eyes, or dark spots (flashes and floaters).
2. Symptoms of scleritis include eye pain and tenderness, redness or swelling of the sclera, blurred vision, frequent tearing, and sensitivity to the light.

Diagnosis

1. Uveitis can be diagnosed by medical history, eye examination, blood tests, skin tests, or X-rays.
2. Scleritis can be diagnosed by eye examination with a slit lamp microscope, blood tests, or X-rays.

Treatment

1. Uveitis can be treated with eye drops containing corticosteroids to reduce inflammation, dilating eye drops to prevent scarring, relax eye muscles to reduce eye twitching, and sometimes surgery.
2. Scleritis can be treated by steroid eye drops, anti-inflammation medications, such as oral antibiotic or antiviral drugs, nonsteroidal anti-inflammatories or corticosteroids (prednisone), and scleral patching or grafts.

The following table summarizes the difference between uveitis and scleritis.

Summary – Uveitis vs Scleritis

Eye inflammation can occur due to infection, allergies, autoimmune disorders, irritation, or injury to the eyes, eyelids, or surrounding tissues. Uveitis and scleritis are two conditions caused by inflammation of the eye. Both these conditions may cause similar symptoms, such as eye pain, photophobia, etc. However, uveitis is the inflammation of the middle layer of the eye, while scleritis is the inflammation of the sclera, which is the white part of the eye. This summarizes the difference between uveitis and scleritis.

FAQ: Uveitis and Scleritis

1. What is the main cause of uveitis?

• The possible causes of uveitis are infection, injury, or an autoimmune or inflammatory disease like multiple sclerosis and ankylosing spondylitis, herpes simplex virus infection, toxoplasmosis, eye injury, and growth in the eye (neoplasia).

2. What is the best treatment for uveitis?

• The treatment options for uveitis are eye drops with an anti-inflammatory medication, like a corticosteroid, dilating eye drops to prevent scarring and relax the eye muscles to cut eye twitches, a corticosteroid injection in or around the eye or oral corticosteroid tablets and surgical management.

3. What is the main cause of scleritis?

• Scleritis is mainly linked to autoimmune diseases. Rheumatoid arthritis and systemic lupus erythematosus are two types of autoimmune diseases that are associated with scleritis. The other causes are infections such as herpes infection, trauma to the eye and medicines that use to treated bone diseases.

4. What are the characteristics of scleritis?

• The typical symptoms of scleritis are severe, penetrating pain that radiates to the forehead, brow, jaw, or sinuses, excessive tenderness, redness or swelling of the sclera, blurred vision, watering eyes, and photophobia.

5. What is the systemic treatment for scleritis?

• The treatment options for scleritis are using prescribed nonsteroidal anti-inflammatory drugs (NSAIDs) and a systemic corticosteroid, like prednisone, for a longer period of time and surgeries like scleral patching or grafts.

Reference:

1. “Uveitis: Symptoms, Causes, and Treatment of Eye Inflammation.” WebMD.
2. “Scleritis.” Johns Hopkins Medicine.

Image Courtesy:

1. “Recurrent scleritis” By Imrankabirhossain – Own work (CC BY-SA 4.0) via Commons Wikimedia

2. “Keratic_precipitate2” By Imrankabirhossain – Own work (CC BY-SA 4.0) via Commons Wikimedia

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