Characteristics of scleritis in patients older than 60 years

Objective: This study aimed to describe the clinical characteristics of scleritis presented de novo in patients older than 60 years of age.

Methods: Type of scleritis, ocular manifestations, previous ocular surgery, and disease association were evaluated in patients older than 60 years with scleritis. Comparisons were made between patients with scleritis older and younger than 60 years.

Results: Patients with scleritis older than 60 years (61 of 195 patients, 31.3%) had more necrotizing scleritis (47.5%, p=0.0001), decrease in vision (57.4%, p=0.0001), peripheral ulcerative keratitis (29.5%, p=0.0001), previous ocular surgery (39.3%, p=0.0001), and disease association (73.8%, p=0.0001) than did patients with scleritis younger than 60 years. Rheumatoid arthritis (p=0.03) and Wegener granulomatosis (p=0.01) were the most common associated diseases.

Conclusions: The detection of scleritis presented for the first time in the elderly, indicates a poor ocular prognosis because it is often associated with necrotizing scleritis, decrease in vision, and peripheral ulcerative keratitis. It has also an ominous systemic prognosis because it is often associated with potentially lethal systemic diseases.