A Successful Treatment of Anterior nodular Scleritis with Topical Corticosteroids in a patient with Crohn's Colitis

Abstract

Scleritis is a chronic, painful, potentially blinding disorder that may also involve the cornea, the adjacent episclera and the unveil tract. It is often associated with ocular complications (corneal changes, glaucoma, cataracts) and in up to 50% of patients it is accompanied by an underlying systemic illness such as rheumatoid arthritis , Wegener’s granulomatosis or inflammatory bowel diseases (IBDs). It is considered to be a relatively rare extra-intestinal ocular manifestation of IBDs (about 2%). This case report represents an anterior nodular scleritis in a patient with Crohn’s colitis who had been primarily treated with topical ophthalmic corticosteroids, and was on infliximab therapy for the underlying disease for three years. Treating a mild form of scleritis with topical corticosteroids could be a reasonable therapeutic option for patients receiving an anti-TNF agent for subjacent inflammatory bowel disease, in order to avoid further immunosuppression with systemic anti-inflammatory drugs.