SKLERA

Dr. Nurul Widiati, SpM

 Episkleritis
Gejala
•  Inflamasi transient (hari-minggu)
•  Usia 20-50 th
•  Keluhan mata merah tanpa gejala iritasi
yang dapat hilang sendiri, terkadang
hilang timbul.
•  Letak lesi superfisial, berwarna merah
salmon (pink salmon)
•  Jenis : diffuse and nodular
•  Penyakit penyerta : Sjogren syndrome,
rheumatoid arthritis, gout, herpes zoster,
syphilis, tuberculosis, rosacea
 Figure 7-21 Nodular episcleritis.

be prescribed for patients bothered by pain. Most patients simply need reassurance that
their condition is not sight-threateni ng and can be treated with lubricants alone. The use
of topical corticosteroids should be kept to a min imum in this benign, self-limited con-
dition. However, in unusual cases of severe disease that does not respond to standard
therapy with lubricants and NSAIDs, a short course of corticosteroids may be necessary.
Terapi
•  Resolve spontan
•  Topikal / oral NSAIDs à sakit
•  Lubricants
•  Topikal kortikosteroid dipertimbangkan
 Skleritis
Gejala
•  Inflamasi lebih berat dari episkleritis
•  Sakit terutama pada malam hari, seringkali
terbangun saat tidur.
•  Sakit menjalar sampai ke kepala dan
wajah di sisi yang sama
Table 7-5 Subtypes and Prevalence of Scleritis
location Subtype Prevalence
Anterior sclera Diffuse scleritis 40%
Nodular scleritis 44%
Necrotizing scleritis 14%
with inflammation (10%)
without inflammation (scleromalacia perforans) (4%)
Posterior sclera 2%
 Necrotizing scleritis 14%
with inflammati on ( 10%)
witho ut inflammation (scleromalacia perforans) (4%)
Posterior sclera 2%

Figure 7-22 Diffuse ante rior scleritis. (Counesy of CharlesS. Bouchard, M D.)
 CHAPTER 7, Clinical Approach to Immune-Relat ed Disorde rs of the External Eye. 219

Figure 7·23 Nodular an terior scle ritis. (COUfresy of Charles S. Bouchard, MD.)

Necrotizing scleritis with inflammation Patients with necrotizing scleritis with inflam -
Figure 7-24 Diffuse anterior scleritis with samll area of necrotizing scleritis. Note also the
partially resolved sclerokeratitis (arrow). (Courtesy of Charles S. Bouchard, MD)
Figure 7·25 Necrotizing anterior scleritis without inflammation (scleromalacia perforans) in a
patient with rheumatoid arthritis. (Courtesy of Charles S. Bouchard, MO)
Terapi
•  Topikal kortikosteroid à mild cases diffuse
anterior and nodular skleritis.
•  Oral NSAIDs à non necrotizing diffuse
•  Ibuprofen 600 mg 3x1
•  Oral kortikosteroid