Treatment and management of scleral disorders

Scleral inflammatory disorders, with their extensive differential diagnoses and sometimes as controversial treatment options, pose both diagnostic and clinical challenges for physicians. Targeted laboratory investigations derived from careful history taking and physical examination are crucial in the early identification of patients with associated systemic conditions. Prompt discrimination between episcleritis and scleritis is of therapeutic importance, as management, prognosis, and complications differ for these diseases. Although immunomodulatory and new biologic agents have improved the management of scleritis, continued studies are warranted to establish effective treatment guidelines across patient populations, especially in refractory cases. (C) 2016 Elsevier Inc. All rights reserved.