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Nodular scleritis - External and Internal Eye
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Nodular scleritis - External and Internal Eye

Contributors: Brandon D. Ayres MD, Christopher Rapuano MD, Harvey A. Brown MD, Sunir J. Garg MD, Lauren Patty Daskivich MD, MSHS
Other Resources UpToDate PubMed


Nodular scleritis is one of the more commonly encountered forms of scleritis. Nodular scleritis is an inflammatory condition affecting the sclera that is often associated with underlying systemic collagen vascular disease, vasculitis, or other auto-immune disease. Nodular scleritis causes severe injection and pain in an elevated area (or nodule) of sclera. It is most commonly seen in middle-aged women. Approximately one third of patients with nodular scleritis have an underlying systemic condition that will cause both eyes to be affected, though sometimes asymmetrically. The scleral inflammation can affect adjacent tissues and, many times, the peripheral cornea can become involved, causing visual loss.


H15.099 – Other scleritis, unspecified eye

95195003 – Nodular scleritis

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

  • Diffuse scleritis
  • Diffuse episcleritis
  • Nodular episcleritis
  • Viral conjunctivitis
  • Bacterial conjunctivitis
  • Allergic conjunctivitis
  • Uveitis
  • Vasculitis
  • Contact lens solution toxicity
  • Toxic conjunctivitis
  • Necrotizing scleritis
  • Inflamed Pinguecula

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Management Pearls

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Drug Reaction Data

Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.

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Last Updated:08/17/2021
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Nodular scleritis - External and Internal Eye
A medical illustration showing key findings of Nodular scleritis : Eye pain, Blurred vision, Photophobia, Bilateral distribution, Sclera/bulbar conjunctiva color change, Sclera/bulbar conjunctiva defect or ulceration, Conjunctival injection, Excessive tearing
Clinical image of Nodular scleritis - imageId=3511295. Click to open in gallery.
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