Skip to content
How It Works
Explore
Ask a Question Resources Pricing
Who It's For
Patients
Decode results, prep for appointments, weigh options.
Caregivers & advocates
Carry the research load for someone you love.
Providers & clinicians
Resources for patients in your practice.
Log In Ask a Question
PubMed This is a summary of 17 peer-reviewed journal articles Updated
Ophthalmology · Scleritis

Building Your Care Team: Specialists & Preparation

At a Glance

Idiopathic scleritis often benefits from coordinated care between an ophthalmologist experienced in uveitis or ocular inflammation and a rheumatologist. Bring eye records, imaging, lab results, medication history, and surgical details to the first visit.

Because scleritis is a rare and potentially vision-threatening condition, your care often requires more than a standard eye exam. A specialized team is often beneficial, as these clinicians treat these conditions more frequently.

Your Eye Specialist: The Uveitis Expert

Your guide may be an ophthalmologist who has completed a fellowship (advanced surgical and medical training) in uveitis or ocular immunology [1][2]. However, an experienced general ophthalmologist can initiate care, referring you as needed.

  • Why they are different: Uveitis specialists focus on inflammatory diseases of the eye. They are trained to differentiate between the subtle subtypes of scleritis and are experienced in using the systemic medications required to calm the immune system [3].
  • What they do: They will perform the detailed slit-lamp exams and imaging needed to monitor your scleral thickness and watch for complications like “melting” or high eye pressure [3][4].

Your Systemic Specialist: The Rheumatologist

You might wonder why you need a “joint doctor” for an eye condition, especially if your blood work is currently negative. In the management of scleritis, the rheumatologist can be an essential partner [5][6].

  • Co-Management: Even in idiopathic cases, rheumatologists are experts in managing the “steroid-sparing” drugs and biologics (like methotrexate or adalimumab) used for scleritis [5][7]. They monitor your blood counts and organ function to ensure these medications are working safely [7].
  • Long-term Surveillance: Since idiopathic scleritis can be the first sign of an autoimmune disease that hasn’t fully appeared yet, a rheumatologist will perform periodic systemic reviews to catch any emerging issues early [8][9].

Preparing for Your First Appointment

Scleritis specialists often act like medical detectives. To help them solve your case and streamline your care, you should bring the following “artifacts” to your first visit:

  • Clinical Notes: Copies of any notes or exam findings from your previous eye doctors [10].
  • Imaging Records: The actual image files or reports from prior B-scans, OCTs, or MRIs [11].
  • Lab Results: Any blood or urine test results from the last year [10].
  • Medication History: A dated list of every eye drop and pill you have used for your eye, including the exact dose and whether it helped or caused side effects [7][12].
  • Surgical Timeline: A list of any eye surgeries (like cataract or pterygium removal) or injuries, as these can be clues to an infectious or “surgical-induced” cause [10][13].

Building the Wider Team

Depending on your specific case, your care might expand to include other specialists:

  • Infectious Disease: If there is any suspicion that a germ (like TB or Syphilis) is causing the inflammation [14].
  • Cornea Specialist: If the inflammation begins to affect the clear front window of your eye or requires a patch graft to repair thinning [15][16].
  • Retina Specialist: If you have posterior scleritis that is causing fluid buildup under the retina [17].

The best teams are those that communicate with each other. Ensure that your eye specialist and your rheumatologist have each other’s contact information and are committed to a “co-management” model [3][5].

Common questions in this guide

Why might I need a rheumatologist if my scleritis is called idiopathic?
Idiopathic means that no underlying cause has been identified, but scleritis can sometimes be the first sign of an autoimmune condition. A rheumatologist can review your overall health over time and help manage medicines such as methotrexate or adalimumab. They may also monitor blood counts and organ function while you take these medicines.
What kind of eye specialist should treat idiopathic scleritis?
An ophthalmologist with fellowship training in uveitis or ocular immunology often has specialized experience with inflammatory eye diseases and scleritis. An experienced general ophthalmologist can begin your evaluation and refer you when needed. The specialist can use detailed eye exams and imaging to follow inflammation, scleral thinning, and pressure inside the eye.
What records should I bring to my first scleritis specialist appointment?
Bring prior eye-care notes, reports or image files from B-scan ultrasounds, OCT scans, or MRIs, and blood or urine test results from the past year. Also bring a dated list of every eye drop and pill you have used, including doses, benefits, and side effects. Include records of past eye surgery or injury, even if it happened years ago.
How do the eye doctor and rheumatologist share care for scleritis?
Your ophthalmologist monitors eye inflammation, scleral thickness, and complications such as thinning or high eye pressure. Your rheumatologist helps assess possible whole-body autoimmune disease and manages systemic medicines, including safety blood tests and organ monitoring. They should exchange contact information and agree on who handles each part of your care, including urgent flare plans.
What symptoms should I mention at my first scleritis visit?
Tell the team when your eye pain began and how it changed with each eye drop or pill. Mention non-eye symptoms such as joint stiffness, a persistent cough, or unusual skin rashes, as well as any prior eye surgery or injury. These details can help clinicians look for an underlying autoimmune, infectious, or surgery-related cause.

Questions to Ask Your Doctor

Curated prompts to bring to your next appointment.

  1. 1.Are you fellowship-trained in uveitis or ocular immunology, and what percentage of your practice is dedicated to inflammatory eye diseases?
  2. 2.How many patients with scleritis do you currently manage, and have you treated cases of my specific subtype (e.g., nodular or posterior)?
  3. 3.Who is the rheumatologist you typically partner with to co-manage systemic medications like methotrexate or biologics?
  4. 4.If my symptoms flare up over a weekend or after hours, how can I reach a specialist who understands scleritis for an urgent assessment?
  5. 5.Will you be personally managing my systemic immunosuppression, or will that be handled entirely by the rheumatologist?

Questions For You

Tap a prompt to share your answer — we'll use it plus this page's context to start a tailored conversation.

References

References (17)
  1. 1

    Anterior segment spectral domain optical coherence tomography imaging of patients with anterior scleritis.

    Levison AL, Lowder CY, Baynes KM, et al.

    International ophthalmology 2016; (36(4)):499-508 doi:10.1007/s10792-015-0153-8.

    PMID: 26597942
  2. 2

    Association of Low Vitamin D Levels With Noninfectious Anterior Uveitis.

    Grotting LA, Davoudi S, Palenzuela D, et al.

    JAMA ophthalmology 2017; (135(2)):150-153 doi:10.1001/jamaophthalmol.2016.4888.

    PMID: 28006052
  3. 3

    Current Approach for the Diagnosis and Management of Noninfective Scleritis.

    Dutta Majumder P, Agrawal R, McCluskey P, Biswas J

    Asia-Pacific journal of ophthalmology (Philadelphia, Pa.) 2020; (10(2)):212-223 doi:10.1097/APO.0000000000000341.

    PMID: 33290287
  4. 4

    Clinical characteristics and ocular complications of patients with scleritis in Japanese.

    Tanaka R, Kaburaki T, Ohtomo K, et al.

    Japanese journal of ophthalmology 2018; (62(4)):517-524 doi:10.1007/s10384-018-0600-y.

    PMID: 29796754
  5. 5

    Noninfectious Autoimmune Scleritis: Recognition, Systemic Associations, and Therapy.

    Nevares A, Raut R, Libman B, Hajj-Ali R

    Current rheumatology reports 2020; (22(4)):11 doi:10.1007/s11926-020-0885-y.

    PMID: 32219644
  6. 6

    Rheumatoid Arthritis Associated Episcleritis and Scleritis: An Update on Treatment Perspectives.

    Promelle V, Goeb V, Gueudry J

    Journal of clinical medicine 2021; (10(10)) doi:10.3390/jcm10102118.

    PMID: 34068884
  7. 7

    Clinical characteristics and efficacy of methotrexate in Japanese patients with noninfectious scleritis.

    Hiyama T, Harada Y, Kiuchi Y

    Japanese journal of ophthalmology 2021; (65(1)):97-106 doi:10.1007/s10384-020-00778-5.

    PMID: 33107015
  8. 8

    Scleritis and Development of Immune-Mediated Disease: A Retrospective Chart Review.

    Morrison T, Gottman M, Do T, et al.

    The Journal of rheumatology 2024; (51(8)):825-830 doi:10.3899/jrheum.2023-0788.

    PMID: 38302174
  9. 9

    ANCA-associated scleritis: impact of ANCA on presentation, response to therapy and outcome.

    Perray L, Nguyen Y, Clavel Refregiers G, et al.

    Rheumatology (Oxford, England) 2024; (63(2)):329-337 doi:10.1093/rheumatology/kead252.

    PMID: 37233203
  10. 10

    Experience of scleritis and episcleritis at a tertiary center in Southern Taiwan.

    Chen YW, Poon YC, Yu HJ, et al.

    Taiwan journal of ophthalmology 2015; (5(1)):19-22 doi:10.1016/j.tjo.2014.10.004.

    PMID: 29018659
  11. 11

    Morphometric Assessment of Sclera and Ciliary Body in Patients with Noninfectious Anterior Scleritis: A Quantitative Study Using Ultrasound Biomicroscopy.

    Liu T, Ma G, Xu W, et al.

    Ocular immunology and inflammation 2024; (32(9)):2000-2007 doi:10.1080/09273948.2024.2315189.

    PMID: 38376887
  12. 12

    Methotrexate for the treatment of noninfectious scleritis.

    Sands DS, Chan SCY, Gottlieb CC

    Canadian journal of ophthalmology. Journal canadien d'ophtalmologie 2018; (53(4)):349-353 doi:10.1016/j.jcjo.2017.11.009.

    PMID: 30119788
  13. 13

    Ocular Pharmacology for Scleritis: Review of Treatment and a Practical Perspective.

    Stem MS, Todorich B, Faia LJ

    Journal of ocular pharmacology and therapeutics : the official journal of the Association for Ocular Pharmacology and Therapeutics 2017; (33(4)):240-246 doi:10.1089/jop.2016.0127.

    PMID: 28355124
  14. 14

    Infectious scleritis: a comprehensive narrative review of epidemiology, clinical characteristics, and management strategies.

    Ghanbari H, Rahimi M, Momeni A, et al.

    Therapeutic advances in ophthalmology 2025; (17()):25158414251357776 doi:10.1177/25158414251357776.

    PMID: 40718796
  15. 15

    Scleritis in patients with granulomatosis with polyangiitis (Wegener).

    Cocho L, Gonzalez-Gonzalez LA, Molina-Prat N, et al.

    The British journal of ophthalmology 2016; (100(8)):1062-5 doi:10.1136/bjophthalmol-2015-307460.

    PMID: 26567022
  16. 16

    Sequential ocular surgeries and multimodal immunosuppression for bilateral, medically refractory seronegative scleritis with severe peripheral corneal stromal thinning: a case report.

    Fidan DG, Butler NJ, Kohanim S, et al.

    BMC ophthalmology 2026; (26(1)).

    PMID: 41992188
  17. 17

    The clinical features of posterior scleritis with serous retinal detachment: a retrospective clinical analysis.

    Dong ZZ, Gan YF, Zhang YN, et al.

    International journal of ophthalmology 2019; (12(7)):1151-1157 doi:10.18240/ijo.2019.07.16.

    PMID: 31341807

This page is for informational purposes only and does not constitute medical advice about idiopathic scleritis. Your ophthalmologist and rheumatologist should guide decisions about testing, medicines, and urgent care for your situation.

Get notified when new evidence is published on Idiopathic scleritis.

We monitor PubMed for new peer-reviewed studies on this topic and email a short summary when something meaningful changes.