Treatment
The following treatments are used for scleritis:
- Non-steroidal anti-inflammatory drugs (NSAIDs): Medication from this group has a pain-relieving and anti-inflammatory effect. Frequently used active ingredients are ibuprofen, naproxen and paracetamol. They are used locally as ointments or creams and as tablets that act throughout the entire body (systemic).
- Cox-2 inhibitors, such as the active ingredient celecoxib: These drugs relieve pain and inhibit inflammation.
- Glucocorticoids (“cortisone”): If NSAIDs do not help sufficiently, doctors use high doses of cortisone in the form of ointments, creams or tablets. Prednisolone is a frequently used active ingredient. Sometimes doctors also inject the cortisone locally (e.g. triamcinolone, dexamethasone).
- Immunosuppressants: These drugs suppress the activity of the immune system. The active substances of first choice are methotrexate, azathioprine, cyclosporin A and mycophenolate mofetil. Cyclophosphamide is also indicated in some cases, especially in necrotizing processes.
- Biologics, e.g. the antibodies infliximab, adalimumab or rituximab: They influence the immune response; however, their effect is still being investigated in studies. Scientists are also researching other biologics for use in scleritis.
- Surgery: If there is a risk of the dermis breaking through (perforation), the defect must be covered with suitable material. Controlling the inflammation is of the utmost importance for success.