What Is The Suggested Medication For Recurring Scleritis In One Eye?

Posted on Thu, 26 Dec 2013

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Thu, 26 Dec 2013 Answered on

Mon, 13 Jan 2014 Last reviewed on

Question : Hi. I have recurring scleritis in one eye, but not always same one, for about ten years. Very painful. Last year it happened three times in a five month period. That was 6months ago. Today it started again. By now I have to begin with 100mg of prednisone and taper over a month. I'm sick of prednisone. I also have Crohns (in remission for 12 yrs), fibromyalgia, DISH, and large benign thyroid nodules. My ophthalmologist suggested asking a rheumatologist and he suggests an eye expert at XXXXXXX What can I expect from the expert? What meds could be used to treat this? The rheumatologist first suspected ankylosing spondylitis but some of the test results didn't support this although I seem to have the symptoms. Instead he diagnosed DISH which he says isn't an immune problem. T3, T4, THS normal. Thyroid antibodies high. Sorry, that should be THE. This computer changed TSH to THS!

Answered by Dr. Dadapeer K (1 hour later)

Brief Answer: It is recurrent scleritis. Detailed Answer: Hello Welcome to health care magic Iam Dr Dadapeer K an ophthalmologist and I answer health problems related to eye. It seems from the history that you are having recurrent scleritis for which you are on treatment with prednisolone. Scleritis is painful inflammatory disease of sclera. It may be associated with inflammatory diseases or autoimmune diseases like crohns disease thyroid diseases rheumatoid arthritis ankylosing spondylitis and many more. Your ophthalmologist has referred you to rheumatologist to find out this underlying association. Coming to your examination reports you arehaving dish disease called as diffuse idiopathic sclerotic hyperostosis which is not a autoimmune disease but a age related degenerative disease. You are having normal thyroid levels but need to rule out euthyroid hyperthyroidism. Coming to the treatment of scleritis, it is by steroid drugs like prednisolone. In cases where steroids cannot be used antimetabolite drugs can be used . However recurrent cases require evaluation to look for the underlying associatied disease and treatment for the same to prevent recurrent attacks. Hope the information is helpful. With regards Dr Dadapeer k

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dadapeer K (11 minutes later)

Doesn't normal t3 and t4 rule out euthyroid hyperthyroidism?

Answered by Dr. Dadapeer K (6 minutes later)

Brief Answer: Euthyroid hyperthyroidism will have normal t3 t4. Detailed Answer: Hello Thank you for the followup Euthyroid hyperthyroidism means hyperthyroidism in presence of normal t3 and t4. This condition is also quiet common and since you are having thyroid nodules in presence of normal levels of t4 t3 and tsh it can be present. Your rheumatologist will be able to diagnose it and its association with scleritis. Hope I have answered your query. Thank you

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dadapeer K (28 hours later)

What are symptoms of hyperthyroidism? I gain weight too easily and feel tired much of the time. Doesn't that sound more like hypothyroidism? Could that cause eye problem? I was on mercaptopurine when my Crohns was active and for more than six years following surgery for a bowel/bladder fistula. I had no side effects from it (I'm allergic to sulfasalazine). Could 6mp be used to control the eye inflammation as well?

Answered by Dr. Dadapeer K (6 hours later)

Brief Answer: Mercaptopurine can be used. Detailed Answer: Hello, Mercaptopurine is a antimetabolite drug most commonly used in the treatment of crohns disease, as you have taken treatment. It is also used in treatment of non responding scleritis. It is specifically used in necrotizing scleritis. It can be used to control the scleritis, but it depends on the severity of scleritis and side effects of the drug. This will be decided by your rheumatologist in consultation with your eye doctor. Hope I have answered your query. Thank you

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar