The Ocular Immunology and Uveitis Foundation


C. Stephen Foster, M.D.

Scleritis. Inflammation of sclera. What exactly is the sclera? The sclera is the white envelope-wall of the eyeball. It is taken for granted by patients and physicians alike, enjoying relative freedom from major, vision-robbing mischief. It is comprised of collagen, one of the forms of so called "connective tissue," and it comprises 4/5 of the tough outer wall of the eyeball; the other 1/5 is comprised of the crystal clear, watch glass structure in the very front of the eye through which we see, the cornea.

Scleritis may occur as a result of various stimuli, the most famous of which is rheumatoid arthritis. But many of the so called connective tissue diseases or collagen vascular diseases may have scleritis as part of their disease spectrum. Indeed, inflammation of the sclera can sometimes be a presenting manifestation of a potentially very serious systemic disease. Sometimes inflammation in the eye will precede extraocular (outside the eye) manifestations of a serious systemic disease by many months or even a few years. This is but one of the many reasons why it is so critical for patients to regularly visit with a physician trained in ophthalmology: an ophthalmologist.

One of our former immunology Fellows from Barcelona, Spain, Maite Sainz de la Maza, was especially interested in diseases of the sclera, and this stimulated her to return to Boston to do a second fellowship under sponsorship of the Fulbright Foundation. Together we wrote the world's only existing book on the sclera which is currently in print. This text is intended to help educate current and future generations of ophthalmologists about the sclera and particularly about inflammation of the sclera and it's importance as a harbinger of systemic disorders.