There are many complications related to the white of the eye (sclera). Some of the disorders that can occur in the sclera are as follows:
Sclera icterus: It is also known as yellow eyes or a jaundiced sclerotic coat. The condition causes the yellowing of the white of the eye and it is associated with health conditions such as liver dysfunction, cholecystitis, hepatitis, and bile duct obstruction. Some researchers state that the yellowing of the eyes (jaundice) takes place within the mucosa layer, that is conjunctiva of the eye, not in the sclerotic coat and the condition ought to be known as mucosa icterus instead. Regardless, doctors refer to yellow eyes or yellowing eyes as “scleral icterus” since the disease causes the white color of the sclerotic coat to change into yellow color. Sclera icterus occurs due to the increased levels of bilirubin – an orange-yellow pigment within the liver in the blood and a blood test is performed to identify the levels of bilirubin.
Blue sclera: Blue sclera refers to a condition where a normally white sclerotic coat turns into blue color. A blue sclerotic coat has a congenitally thinner-than-normal sclerotic coat due to the thinning of collagen fibers of the sclera and this reduction of the sclerotic coat occurs due to certain medical conditions such as congenital diseases such as Marfan’s syndrome, incontinentia pigmenti, Ehlers Danlos syndrome, and non-inherited diseases such as iron deficiency anemia. The blue color of the eye corresponds to the color of the underlying choroidal tissue since the thinning of the collagen fibers exposed the underlying choroid.
Scleritis: Scleritis is the inflammation of white of the eye – sclera. It is a serious eye disorder and usually a lot more painful and nearly up to 50% of scleritis cases are due to autoimmune diseases such as rheumatoid arthritis and other diseases such as inflammatory bowel disease, progressive systemic sclerosis. It usually develops gradually, and most patients experience intense, piercing eye pain for several days. When there is eye movement, the pain tends to be worse and this is because the inflammation usually begins in one region and spreads across the sclera. Scleritis can cause permanent harm to eye and vision loss. Frequent complications associated with scleritis are inflammation of the cornea – keratitis, glaucoma, uveitis, and cataract and it is usually treated with nonsteroidal anti-inflammatory drugs (NSAIDs) and corticosteroids. In certain cases, immunosuppressive drugs can be administered. It can present for months or even years before going into long-term remission.
Episcleritis: The episclera is the tissue layer that lies at the top of the sclerotic coat and below the mucous membrane. The inflammation of the episclera is known as episcleritis and it can be of two forms – nodular episcleritis is the redness and inflamed tissue present on the distinct and elevated space superjacent to the sclerotic coat, and simple episcleritis occurs due to the enlarged episcleral blood vessels but devoid of nodules. The cause of the redness or episcleritis is unknown but this eye condition is said to be associated with disorders such as atrophic arthritis, colitis, lupus, rosacea, gouty arthritis, and so on. Most cases of episcleritis subside within 2 to 3 weeks on their own. However, oral pain relievers and cold artificial tears are sometimes prescribed if there is discomfort.
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