The cause of acute "inflammations" of the sclera is still a debatable subject, and the treatment is empiric, nonspecific, prolonged and often unsuccessful.
In Duke-Elder's textbook1 nine and one-half pages of print suffice to describe the nonpyogenic inflammations of the sclera. He has classified them into episcleritis (nodular episcleritis and episcleritis periodica fugax) and scleritis (anterior scleritis, brawny scleritis, sclerokeratitis and posterior scleritis or sclerotenonitis). These different types shade imperceptibly into one another both clinically and pathologically, without any accurate line of demarcation. All types may be complicated by sclerosing keratitis, uveitis or both. Suggested etiologic factors include gout, rheumatism, tuberculosis, allergy, focal infection and menstruation.
The lesion is characterized especially by the presence of mononuclear lymphocytes, tightly packed masses of which make up the bulk of the inflammatory nodules or the areas of diffuse swelling. . . . In the superficial episcleral lesions the conjunctiva is infiltrated
DUGGAN WF. ROLE OF ANOXIA IN THE PRODUCTION OF EPISCLERITIS AND SCLERITIS: TREATMENT WITH VASODILATORS. Arch Ophthalmol. 1941;25(1):113–121. doi:10.1001/archopht.1941.00870070127013
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