Scleritis: Symptoms, Causes, and Treatment

The most defining symptom is a deep, severe, aching pain in the eye that may spread to the forehead, face, or jaw. The eye often takes on a deep red or purple-red color that is distinct from ordinary irritation or pinkeye.

Blurred vision and sensitivity to light are also common with scleritis. Pain may intensify with eye movement or at night, which can make it difficult to sleep or concentrate during the day.

Scleritis is often confused with episcleritis (inflammation of the thin tissue layer over the sclera) or conjunctivitis (pinkeye). Episcleritis typically causes redness with mild discomfort and often resolves without treatment. Conjunctivitis produces a gritty, itchy sensation. Scleritis, by contrast, causes a persistent, deep pain that does not go away on its own and can threaten vision if not addressed.

When scleritis is connected to an autoimmune condition, it may come alongside joint pain, fatigue, fever, or skin changes. Reporting these broader symptoms to your care team is important, as they help form a complete picture of what is driving the inflammation.

Scleritis almost never clears up on its own. Because it is usually driven by an underlying condition, the inflammation tends to persist or worsen without medical intervention. Delaying care increases the risk of complications including permanent vision loss, so it is important to seek an evaluation as soon as symptoms appear.

You should seek urgent care if you notice a sudden loss or change in vision, severe eye pain that does not improve, or if the white part of your eye appears unusually thin or has a bluish or dark tint. These signs may indicate necrotizing scleritis, the most serious form, which requires immediate attention to prevent permanent damage to the eye.

Not always, but roughly half of all scleritis cases are connected to an autoimmune disease. If no underlying condition is found right away, your doctor will continue to monitor you closely, because systemic symptoms can sometimes develop months after the eye condition is first diagnosed. Ongoing follow-up is an important part of care.

Episcleritis affects only the thin surface layer over the sclera and usually causes redness with mild discomfort. It often improves on its own within a few weeks. Scleritis goes deeper into the sclera itself, causes much more intense pain, and carries a greater risk to vision. If you are unsure which condition you have, an examination by an eye doctor is the only reliable way to tell.

The length of treatment varies widely depending on the cause and how your body responds. Mild cases without an underlying systemic condition may resolve within a few weeks. Cases linked to autoimmune disease often require longer-term management to prevent recurrence, and your care team may adjust your treatment plan over time based on how well inflammation is controlled.

Scleritis in children is uncommon but can occur, particularly in those with an autoimmune condition. Because children's eyes are still developing, early and careful management is especially important to prevent lasting effects on their vision. If your child has severe eye pain or persistent redness, an evaluation by an eye doctor is strongly recommended.