What Is Scleritis?

What is scleritis? Scleritis is inflammation of the sclera, the white outer layer of the eye. It can cause deep eye pain, redness, tenderness, light sensitivity, and blurry vision. Unlike a mildly irritated eye, scleritis can become serious and should be evaluated by an eye doctor, especially when pain is intense, vision changes, or redness does not improve.

At Barnet Dulaney Perkins Eye Center, a painful red eye starts with careful evaluation. A comprehensive eye exam can help your doctor identify whether symptoms come from scleritis, episcleritis, dry eye, infection, corneal inflammation, glaucoma, injury, or another eye condition.

What Scleritis Means

The sclera provides the eye with structure and helps protect the delicate tissues inside. When this layer becomes inflamed, the eye may look red or purple-red and feel sore, tender, or deeply painful.

Scleritis may affect the front of the eye (anterior scleritis) or the back of the eye (posterior scleritis). Anterior scleritis is more common. Posterior scleritis can be harder to recognize because it may cause pain, headache, blurry vision, or changes inside the eye without the same obvious surface redness.

Symptoms Of Scleritis

Scleritis symptoms can vary, but they often feel more intense than routine eye irritation. 

Common symptoms include:

• Deep, aching, or boring eye pain
• Redness in part or all of the white of the eye
• Eye tenderness
• Pain that worsens with eye movement
• Light sensitivity
• Tearing
• Blurry or decreased vision
• Headache or pain around the brow, temple, cheek, or jaw

If you have sharp or severe eye pain, this related guide on stabbing eye pain can help explain why prompt evaluation matters. If your main symptom is vision change, the guide to blurry vision causes and treatment may also help with the next step.

Scleritis Vs. Episcleritis

Scleritis and episcleritis can both make the eye look red, but they are not the same condition. Episcleritis affects a more superficial layer of tissue and often causes milder discomfort. Scleritis involves deeper inflammation and may cause more severe pain, tenderness, and possible vision changes.

Because the two can look similar at home, do not try to diagnose the difference by appearance alone. An eye doctor may use a slit-lamp exam, history of symptoms, eye pressure testing, dilation, imaging, or other tests to determine which layer of the eye is inflamed.

What Causes Scleritis?

Sometimes scleritis has no clear cause. In other cases, it may be linked to an autoimmune or inflammatory condition such as rheumatoid arthritis, lupus, inflammatory bowel disease, or certain forms of vasculitis. Less commonly, scleritis may follow infection, trauma, or eye surgery.

That connection matters because treatment may need more than eye drops. Your eye doctor may ask about joint pain, rashes, digestive symptoms, recent illness, surgery history, or known autoimmune disease. In some cases, your care may involve coordination with your primary care provider or a rheumatologist.

How Scleritis Is Diagnosed

Diagnosis starts with an eye exam and a detailed history of symptoms. Your doctor may check visual acuity, intraocular pressure, the front of the eye (the sclera and cornea), and the inside of the eye after dilating your pupils.

Testing may include:

• Slit-lamp examination
• Dilated eye exam
• Eye pressure measurement
• Retinal evaluation when vision changes are present
• Imagine if posterior scleritis is suspected
• Lab testing when autoimmune or infectious causes are possible

Because scleritis can overlap with corneal, retinal, and pressure-related concerns, your doctor may also consider related care pathways such as cornea care, retina care, or glaucoma treatment when symptoms or exam findings point that direction.

Scleritis Treatment Options

Scleritis treatment depends on the cause, severity, and whether the inflammation affects the front or back of the eye. Your doctor’s first goal is to reduce inflammation, relieve pain, protect vision, and identify any underlying health conditions.

Treatment may include oral anti-inflammatory medication, prescription eye medication, oral corticosteroids, immunomodulating medication, or treatment for infection when present. More severe, recurrent, posterior, or vision-threatening cases may need closer monitoring and coordination with another medical specialist.

Do not use leftover prescription drops or start someone else’s medication for a painful red eye. Some conditions can worsen without the right diagnosis.

When To Call An Eye Doctor

Schedule care promptly if you notice a painful red eye, especially if the pain feels deep, keeps you awake, worsens with eye movement, or comes with light sensitivity. This guide to photophobia and light sensitivity explains why light sensitivity can point to inflammation or another eye condition.

Call right away or seek urgent care if you have severe eye pain, sudden vision loss, new floaters or flashes, eye trauma, chemical exposure, or rapidly worsening redness and swelling.

Get Help For A Painful Red Eye In Arizona

A red, painful eye should not be a guessing game. Barnet Dulaney Perkins Eye Center can evaluate eye pain, redness, light sensitivity, and vision changes across Arizona. If you are concerned about scleritis or another inflammatory eye condition, schedule online or call 602-955-1000 to determine the next best step.