Treatment of Scleritis in Posterior or Necrotizing Disease

Posterior scleritis and necrotizing scleritis represent the most severe and urgent presentations of scleritis. They require a fundamentally different — and far more intensive — therapeutic approach than anterior non-necrotizing forms of the disease.

Clinical Scenario

This protocol applies to patients with posterior scleritis or necrotizing scleritis — presentations in which prompt, aggressive systemic intervention is necessary to control scleral inflammation and prevent irreversible structural damage.

Treatment Approach

Management involves high-dose systemic corticosteroids to induce disease remission and bring scleral inflammation under control. The specific regimen — including the choice of preparation, starting intensity, and tapering schedule — depends on the urgency of the clinical picture.

The complete structured protocol, including full dosing, sequencing, and decision criteria, is available via the link below.

Goal: disease remission with control of scleral inflammation

Instant Access to Structured Evidence-Based Regimens

References

DOI: 10.1016/j.survophthal.2005.04.001

Patients with posterior or necrotizing scleritis need much more intensive and urgent therapy than those presenting with anterior non-necrotizing disease.
Corticosteroids are usually reserved for patients who do not respond to cox-inhibitors or those with posterior or necrotizing disease.
Systemic corticosteroids may be administered orally or intravenously at high doses to induce disease remission.

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