Refractive changes in patients with autoimmune scleritis

Scleritis is a severe inflammatory disease characterized by edema and inflammatory cell infiltration of the sclera [1, 2]. Without treatment, the condition may be progressively destructive, leading sometimes to loss of vision or loss of the eye [1, 2]. About 30–50% of all scleritis patients have an associated systemic disease [1]. Most common associations are: rheumatoid arthritis (50–60%) and primary systemic vasculitis like Wegener’s granulomatosis (20%) followed by inflammatory bowel disease (15%) [1]. Complications have been reported in almost 60% of scleritis patients [1, 2]. In their series, Jabs et al. found decreased visual acuity in 15.9% of patients during the inactive phase of the disease [1]. Sainz de la Maza et al. described this complication in 37% of their patients [2]. Some authors have reported transient myopia during the acute phase of anterior diffuse [3] and necrotizing scleritis [4]. In one report transient myopia developed after cataract surgery in a patient with necrotizing scleritis [5]. Secondary astigmatism in patients with necrotizing scleritis has also been found. The authors associated this finding to scleral thinning [6]. To the best of our knowledge, no attempt to systematically characterize the refractive changes associated to scleritis has been done. Our purpose was to determine the clinical characteristic, scleral rigidity, and refractive changes in a cohort of scleritis patients who were followed up since admittance until resolution of inflammation.