Definition and research guide
This page combines a MeSH definition, publication statistics and selected research abstracts. It is a starting point for reading the literature, not a medical textbook or a systematic evidence review.
Content available: 4 complete abstracts (741 words), 10 references. Full article text is not stored or reproduced here; follow the PMID, DOI or PMC links to read the original sources and their access terms.
Definition
Refers to any inflammation of the sclera including episcleritis, a benign condition affecting only the episclera, which is generally short-lived and easily treated. Classic scleritis, on the other hand, affects deeper tissue and is characterized by higher rates of visual acuity loss and even mortality, particularly in necrotizing form. Its characteristic symptom is severe and general head pain. Scleritis has also been associated with systemic collagen disease. Etiology is unknown but is thought to involve a local immune response. Treatment is difficult and includes administration of anti-inflammatory and immunosuppressive agents such as corticosteroids. Inflammation of the sclera may also be secondary to inflammation of adjacent tissues, such as the conjunctiva.
Definition: NLM Medical Subject Headings (MeSH) scope note (Public domain (U.S. National Library of Medicine); attribution requested). View the MeSH record.
Also known as: Scleritides; Episcleritis; Episcleritides; Necrotizing Scleritis; Necrotizing Scleritides; Scleritides, Necrotizing; Scleritis, Necrotizing.
Where it fits in the MeSH classification
- Broader topics
- Scleral Diseases
Research landscape
PubMed indexes 1,741 records tagged with the MeSH heading “Scleritis” (counts retrieved 2026-11-04). 429 of them (24.6%) were published from 2020 onward, and the busiest period so far is 2010-2019 with 530 records.
Reviews account for 198 records (11.4%) and meta-analyses for 2. Randomized controlled trials number 7 (0.4%) as a share of all records on the topic. Randomized trials make up only a small share of this literature, so much of what is known comes from laboratory, observational or descriptive work.
Show the data
| Period | Records |
|---|---|
| through 1999 | 345 |
| 2000-2009 | 437 |
| 2010-2019 | 530 |
| 2020 onward | 429 |
Publication-type chart data
| Type | Records | Share |
|---|---|---|
| Reviews | 198 | 11.4% |
| Meta-analyses | 2 | 0.1% |
| Randomized controlled trials | 7 | 0.4% |
Method: PubMed query "Scleritis"[MeSH Terms] with publication-type and date filters, retrieved 2026-11-04.
Reading the evidence in eye, ear, nose and throat
Eye, hearing, nose and throat studies rely on specialist tests (visual acuity, eye pressure, audiograms, scopes) and on patient-reported symptoms, which vary between people and with age. Some conditions improve without treatment, so comparison groups matter. Nothing on this page is advice about diagnosis or treatment; sudden loss of sight or hearing needs urgent care from a qualified clinician. Check how the outcome was tested, the age of the people studied and how long they were followed.
Evidence from open-access studies
These open-access studies come from PubMed’s best-match results for this heading (papers whose main topic it is), ranked here by citation count, with one recent addition. Each abstract is reproduced in full under its recorded open licence so that you can read the authors’ own words. They illustrate the literature; they are not a systematic summary of it. Citation counts measure attention, not reliability or clinical benefit.
| Study / authors | Year | Source label / design | Europe PMC citations | Licence / source |
|---|---|---|---|---|
| Incidence, prevalence, and risk factors of infectious uveitis and scleritis in the United States: A claims-based analysis | 2020 | Research article Design not recorded in structured metadata | 57 | cc by PMID 32841267 · DOI · PMC7447056 |
| New Potential Weapons for Refractory Scleritis in the Era of Targeted Therapy | 2020 | Research article Design not recorded in structured metadata | 27 | cc by PMID 32410867 · DOI · PMC7201583 |
| Comprehensive profiling of extracellular vesicles in uveitis and scleritis enables biomarker discovery and mechanism exploration | 2023 | Research article Design not recorded in structured metadata | 18 | cc by PMID 37322475 · DOI · PMC10273650 |
| Ophthalmic involvement in VEXAS syndrome and its influence on mortality: insights from the international AIDA network registry | 2026 | Research article Design not recorded in structured metadata | 0 | cc by PMID 42404884 · DOI · PMC13327857 |
Incidence, prevalence, and risk factors of infectious uveitis and scleritis in the United States: A claims-based analysis [1]
Abstract reading summary — source excerpts
- Opening excerpt
- BackgroundOcular inflammation causes significant visual morbidity in the United States, yet little is known about the epidemiology of infectious uveitis and scleritis.
- Closing excerpt
- Rates varied by age, sex, race, and medical comorbidities, and may reflect differential susceptibility to various infectious agents with disparate geographic distributions within the United States.
- Interpretation limits
- Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (234 words)
BackgroundOcular inflammation causes significant visual morbidity in the United States, yet little is known about the epidemiology of infectious uveitis and scleritis. This study aims to evaluate the epidemiology of infectious uveitis/scleritis employing a large national medical claims database.MethodsThis was a retrospective, case-control study, employing Optum's de-identified Clinformatics® Data Mart Database, containing data from 21.5 million privately insured individuals with enrollment for at least 15 months within 2007-2015. Inclusion in the uveitis/scleritis sample required an index uveitis/scleritis diagnosis based on International Classification of Diseases, Ninth Revision (ICD-9) codes. Exclusion criteria included index date within 3 months after intraocular surgery. Rates for uveitis/scleritis were determined by anatomic site. Multivariable logistic regression analyses were performed to determine odds ratios for the incidence and prevalence of uveitis/scleritis by anatomic category.FindingsInfectious etiologies accounted for less than 20% of uveitis/scleritis, with mean rates of 18.9 (incidence) and 60.6 (prevalence) per 100,000 persons. The mean prevalences of infectious anterior, intermediate, posterior, panuveitis, and scleritis were 27.7, 0.17, 23.4, 4.4, and 4.6, per 100,000, respectively. Overall risk of prevalent infectious uveitis/scleritis increased with age (OR>3.3 for each decade over age 18, pConclusionsThe incidence and prevalence of infectious uveitis/scleritis in the United States were higher than previously reported estimates but remained lower than in developing countries. Rates varied by age, sex, race, and medical comorbidities, and may reflect differential susceptibility to various infectious agents with disparate geographic distributions within the United States.
Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 32841267 · DOI · PMC7447056
New Potential Weapons for Refractory Scleritis in the Era of Targeted Therapy [2]
Abstract reading summary — source excerpts
- Opening excerpt
- ObjectiveTo assess the efficacy of biologic drugs, beyond tumor necrosis factor- (TNF-) α inhibitors, in the management of noninfectious refractory scleritis, either idiopathic or associated with systemic immune-mediated disorders.
- Closing excerpt
- ConclusionsOur results, though limited to a low number of patients, highlight the effectiveness of different biologic therapies in the treatment of noninfectious refractory scleritis, showing to control scleral inflammation and allowing a significant reduction in the number of relapses.
- Interpretation limits
- Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (188 words)
ObjectiveTo assess the efficacy of biologic drugs, beyond tumor necrosis factor- (TNF-) α inhibitors, in the management of noninfectious refractory scleritis, either idiopathic or associated with systemic immune-mediated disorders. Patients and Methods. This is a retrospective study assessing the efficacy of several biologic agents (rituximab, anakinra, tocilizumab, and abatacept) and the small molecule tofacitinib in the treatment of scleritis through assessment of scleral inflammation and relapses, as well as treatment impact on best-corrected visual acuity (BCVA) and safety profile.ResultsFourteen patients (19 eyes) were enrolled in the study. Scleritis inflammatory grading significantly improved from baseline to 3 months (p = 0.002) and from baseline to the last follow-up visit (p = 0.002). Scleritis relapses significantly decreased between the 12 months preceding and following biologic therapy (p = 0.007). No differences regarding BCVA were observed (p = 0.67). Regarding adverse events, only one patient developed pneumonia and septic shock under rituximab treatment.ConclusionsOur results, though limited to a low number of patients, highlight the effectiveness of different biologic therapies in the treatment of noninfectious refractory scleritis, showing to control scleral inflammation and allowing a significant reduction in the number of relapses.
Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 32410867 · DOI · PMC7201583
Comprehensive profiling of extracellular vesicles in uveitis and scleritis enables biomarker discovery and mechanism exploration [3]
Abstract reading summary — source excerpts
- Opening excerpt
- BackgroundUveitis and posterior scleritis are sight-threatening diseases with undefined pathogenesis and accurate diagnosis remains challenging.
- Closing excerpt
- ConclusionsThis study provides a proteomic landscape of plasma and EVs involved in ankylosing spondylitis-related uveitis, Behcet's disease uveitis, Vogt-Koyanagi-Harada syndrome, and posterior scleritis, offers insights into disease pathogenesis, identifies valuable biomarker candidates, and proposes promising therapeutic agents.
- Interpretation limits
- Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (214 words)
BackgroundUveitis and posterior scleritis are sight-threatening diseases with undefined pathogenesis and accurate diagnosis remains challenging.MethodsTwo plasma-derived extracellular vesicle (EV) subpopulations, small and large EVs, obtained from patients with ankylosing spondylitis-related uveitis, Behcet's disease uveitis, Vogt-Koyanagi-Harada syndrome, and posterior scleritis were subjected to proteomics analysis alongside plasma using SWATH-MS. A comprehensive bioinformatics analysis was performed on the proteomic profiles of sEVs, lEVs, and plasma. Candidate biomarkers were validated in a new cohort using ELISA. Pearson correlation analysis was performed to analyze the relationship between clinical parameters and proteomic data. Connectivity map database was used to predict therapeutic agents.ResultsIn total, 3,668 proteins were identified and over 3000 proteins were quantified from 278 samples. When comparing diseased group to healthy control, the proteomic profiles of the two EV subgroups were more correlated with disease than plasma. Comprehensive bioinformatics analysis highlighted potential pathogenic mechanisms for these diseases. Potential biomarker panels for four diseases were identified and validated. We found a negative correlation between plasma endothelin-converting enzyme 1 level and mean retinal thickness. Potential therapeutic drugs were proposed, and their targets were identified.ConclusionsThis study provides a proteomic landscape of plasma and EVs involved in ankylosing spondylitis-related uveitis, Behcet's disease uveitis, Vogt-Koyanagi-Harada syndrome, and posterior scleritis, offers insights into disease pathogenesis, identifies valuable biomarker candidates, and proposes promising therapeutic agents.
Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 37322475 · DOI · PMC10273650
Ophthalmic involvement in VEXAS syndrome and its influence on mortality: insights from the international AIDA network registry [4]
Abstract reading summary — source excerpts
- Opening excerpt
- Orbital inflammation is the most common presentation of VEXAS, with any orbital structure potentially affected.
- Closing excerpt
- Ophthalmic involvement is common in VEXAS syndrome and signals a poorer prognosis in terms of mortality, highlighting the need for close monitoring.
- Interpretation limits
- Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (105 words)
Orbital inflammation is the most common presentation of VEXAS, with any orbital structure potentially affected. Non-sight-threatening and uncomplicated anterior non-granulomatous uveitis and anterior diffuse scleritis follow in frequency, along with episcleritis. Ophthalmic involvement was significantly associated with relapsing polychondritis (p = 0.014), with an increased chance of a fatal outcome (RR 5.87, p = 0.016) and independently predicts a higher mortality rate (OR 3.72, p = 0.026). Treatment of ophthalmic involvement showed full or partial response to glucocorticosteroids alone in 66.7% of cases. Ophthalmic involvement is common in VEXAS syndrome and signals a poorer prognosis in terms of mortality, highlighting the need for close monitoring.
Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 42404884 · DOI · PMC13327857
Key reviews and meta-analyses
The most cited review-type papers among PubMed’s best-match results for this heading, listed with bibliographic details only. Follow the links for the full text and access terms.
- Research article Expert panel recommendations for the use of anti-tumor necrosis factor biologic agents in patients with ocular inflammatory disorders [5]
- Research article Scleritis [6]
- Research article Scleritis and peripheral ulcerative keratitis [7]
- Research article Combining Biologics in Inflammatory Bowel Disease and Other Immune Mediated Inflammatory Disorders [8]
- Research article Tumor necrosis factor antagonists: preliminary evidence for an emerging approach in the treatment of ocular inflammation [9]
- Research article Ophthalmic manifestations in patients with inflammatory bowel disease: A review [10]
References
- Zhang Y, Amin S, Lung KI, Seabury S, Rao N, Toy BC. Incidence, prevalence, and risk factors of infectious uveitis and scleritis in the United States: A claims-based analysis. . 2020. PMID 32841267 · DOI · PMC7447056
- Fabiani C, Sota J, Sainz-de-la-Maza M, Pelegrín L, Emmi G, Lopalco G, et al.. New Potential Weapons for Refractory Scleritis in the Era of Targeted Therapy. . 2020. PMID 32410867 · DOI · PMC7201583
- Wu L, Zhou L, An J, Shao X, Zhang H, Wang C, et al.. Comprehensive profiling of extracellular vesicles in uveitis and scleritis enables biomarker discovery and mechanism exploration. . 2023. PMID 37322475 · DOI · PMC10273650
- Sota J, Hinojosa-Azaola A, Martín-Nares E, Sfriso P, Bindoli S, Hissaria P, et al.. Ophthalmic involvement in VEXAS syndrome and its influence on mortality: insights from the international AIDA network registry. . 2026. PMID 42404884 · DOI · PMC13327857
- Levy-Clarke G, Jabs DA, Read RW, Rosenbaum JT, Vitale A, Van Gelder RN. Expert panel recommendations for the use of anti-tumor necrosis factor biologic agents in patients with ocular inflammatory disorders. Ophthalmology. 2014. PMID 24359625 · DOI
- Okhravi N, Odufuwa B, McCluskey P, Lightman S. Scleritis. Surv Ophthalmol. 2005. PMID 15967190 · DOI
- Galor A, Thorne JE. Scleritis and peripheral ulcerative keratitis. Rheum Dis Clin North Am. 2007. PMID 18037120 · DOI · PMC2212596
- Hirten RP, Iacucci M, Shah S, Ghosh S, Colombel JF. Combining Biologics in Inflammatory Bowel Disease and Other Immune Mediated Inflammatory Disorders. Clin Gastroenterol Hepatol. 2018. PMID 29481970 · DOI
- Theodossiadis PG, Markomichelakis NN, Sfikakis PP. Tumor necrosis factor antagonists: preliminary evidence for an emerging approach in the treatment of ocular inflammation. Retina. 2007. PMID 17420690 · DOI
- Troncoso LL, Biancardi AL, de Moraes HV, Zaltman C. Ophthalmic manifestations in patients with inflammatory bowel disease: A review. World J Gastroenterol. 2017. PMID 28932076 · DOI · PMC5583569
About this article
- Sources
- NLM Medical Subject Headings (definition, synonyms); NCBI PubMed (counts, identifiers); Europe PMC (open-access abstracts and citation counts).
- Verification
- Every reference was resolved against PubMed on 2026-11-04; title, year and DOI matched.
- Review state
- automated source verified; no human expert review has been recorded yet.
- Version
- 1, last updated 2026-11-04.
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Evidence strength
EvidenceHelix's computed view of the study designs behind this topic: how common meta-analyses, randomized trials and reviews are, how recent the literature is, and a plain-language reading. It describes the design mix of the literature. It is not a quality appraisal of any study, and it is not medical advice.