Scleritis with no apparent cause

[infin8klf]

I was recently diagnosed with mild anterior diffuse scleritis.  I am 22 years old.  It has flared up a total of three times since diagnosis (3 months ago), and were all treated with prednisone eye drops.  It's currently only flared up on my right eye, but my left eye has started to have the aching and pain pulses into my temple like my other eye did.  I have eczema (had since I was a small child) and psoriasis (started up at around 15yrs old).  I have occasional joint inflammation (hands, feet, knees), normally in the mornings, at night, and when I'm doing physical labor.  I have had some blood tests done, all coming back normal.  They checked for a Rheumatoid factor, but came up negative.  My primary care manager seems to think I'm making up my symptoms (I've only seem him once and only because my ophthalmologist recommended me to go as soon as possible).  My PCM left me with a bad taste in my mouth.  I'm not sure where else to go since I have Tricare (lack of options), and he was supposed to be the best PCM in my area.  He won't send me to a rheumatologist and he feels no need to follow up.   I'm just trying to get a better feel of how important it is to follow up and investigate the matter further.  Any suggestions would help greatly!

[Ray T Oyakawa, MD]

This should be treated and followed by your ophthalmologist.  Prednisone drops,  Xibrom drops, and indomethecin oral pills (usually starting low and increase as tolerated) and monitoring of your intraocular pressure.

[infin8klf]

Ok, what can generally come from having scleritis without finding the underlying cause and treating it?  There's not much information online about it, and with as much research as I've done, it only seems to concentrate on the more serious aspects of it, which I apparently don't have right now.  What do I have to look forward to?  I've already started having light sensitivity - I've never worn sunglasses in my life, and I ended up having to invest in a decent pair last month as I was getting headaches from it.  Sorry for the questions...  :)

[Ray T Oyakawa, MD]

A cause is not found in most cases of scleritis.  However, a referral to a rheumatologist is the standard of care.  See of your ophthalmologist can be of help.  I would recommend paying cash to see a specialist.  I am already paying cash for a significant part of my care as a doctor 62 years old.  Left to insurance companies my wife and I would have many more problems.  We ran through our $3k deductable by March 17 of this year. I do not get generic drugs.

Dr. O.

[infin8klf]

Oh, and I also have punctal plugs for dry eye syndrom - had those put in when I was 19.  Not sure if that helps.