Index

Acanthamoeba, protozoal scleri­tis, 266-267

Actinomycetic scleritis, 253-254 Acute diffuse idiopathic orbital

inflammation, differential diagnosis, 118

Alkaptonuria, 281 Allergic granulomatous angiitis,

211-212 diagnosis, 212 epidemiology, 211-212 laboratory findings, 212 noninfectious scleritis, 151 ocular manifestations, 212 systemic manifestations, 212

Amyloidosis, 179,281 Angle-closure glaucoma, 129 Ankylosing spondylitis, 193-198

anterior uveitis, 197 articular involvement, 195-196 diagnosis, 198 epidemiology, 194 extraarticular systemic manifes-

tations, 196-197 HLA-B27,42 laboratory findings, 198 noninfectious scleritis, 197-198 ocular manifestations, 197 radiological evaluation, 198 systemic manifestations, 195-

197 Annular ciliochoroidal detach­

ment, posterior scleritis, 115-116, 123-124

Anterior ciliary artery, 14, 17, 19 Anterior ciliary vein, 19 Anterior conjunctival plexus, 14 Anterior episcleral arterial circle,

14, IS, 18

Anterior scleral foramen, anat­omy, 11-12

Anterior segment fluorescein an­giography, 20

episcleritis, 82-86 scleritis, 82-86

Anterior uvea, physical examina­tion, 73-74

Anterior uveitis ankylosing spondylitis, 197 Crohn's disease, 206 episcleritis, 98, 99 Reiter's syndrome, 201 rheumatoid arthritis, 183-184 scleritis, 98, 99 ulcerative colitis, 206

Antiinflammatory agents, 299, 304 Anti-neutrophil cytoplasmic anti­

body, 77-78 Anti-nuclear antibody, 76-77 Antibody titer, against infectious

organisms, 80-81 Antigen-presenting cell, 38 Aphthous ulcer, Beh~et's disease,

66 Atopy, Cogan's syndrome, 222-

223 Autoimmune disease, 45

pathogenesis, 50-52 Autoimmunity, immune re­

sponse, 45-46 mechanisms, 46

Azathioprine, 302, 303

B lymphocyte, 36 Bacterial scleritis, 243-246 Basophil, 39-40

secretory products, 40

Beh~et's disease, 216-218 aphthous ulcer, 66 diagnosis, 218 epidemiology, 216 episcleritis, 218 laboratory findings, 218 noninfectious scleritis, 217-

218 ocular manifestations, 217-

218 systemic manifestations, 216-

217 treatment, 301, 304

Bekhterev's disease. See Ankylo­sing spondylitis

Bilirubin, scleral pigment deposi­tion, 283

Biopsy diffuse scleritis, 163-164 episcleritis, 88-89 infectious scleritis, 163-164 necrotizing scleritis, 163-164 nodular scleritis, 163-164 noninfectious necrotizing scleri-

tis, 161-162 noninfectious recurrent diffuse

scleritis, 162 noninfectious recurrent nodu­

lar scleritis, 162 noninfectious recurrent

nonnecrotizing scleritis, 162

scleritis, 88-89 technique, 163

Blood test episcleritis, 74-81 scleritis, 74-81

Blue sclera, 283-288 Buphthalmos, 286-287

309

310

Clq-binding assay, 79 Calcium, scleral mineral deposi­

tion, 282-283 age-related,283

Cataract, 130 episcleritis, 99 rheumatoid arthritis, 184 scleritis, 99

Central retinal artery, 17 Central retinal vein, 19 Chemical injury-associated scleri­

tis, 226 Chemosis, posterior scleritis,

121-122 Chlamydial scleritis, 253 Chlorambucil, 304 Choroid, noninfectious scleritis,

148 Choroidal fold

posterior scleritis, 123 scleritis, 115

Choroidal melanoma, 122 Chronic granulomatous inflam­

mation, 138 Chronic nongranulomatous in­

flammation, 138 Churg-Strauss syndrome, 211-

212 diagnosis, 212 epidemiology, 211-212 laboratory findings, 212 noninfectious scleritis, 151 ocular manifestations, 212 systemic manifestations, 212

Ciliary body, noninfectious scleri­tis, 148

Circulating immune complex, 78-79

rheumatoid arthritis, 186-187 Cogan's syndrome, 221-222

atopy, 222-223 clinical manifestations, 221-

222 episcleritis, 222 laboratory findings, 222 noninfectious scleritis, 221-222

Collagen, 7-8, 23, 25 fetal sclera, 7-8 immune response, 47 necrotizing scleritis, 50 rheumatoid arthritis, 50 scleritis, 50

Collagen bundle, 20-21 Collagenase, 27

immune response, 47

Coloboma, 287 Complement, 79 Computerized tomography

episcleritis, 87 posterior scleritis, 117 scleritis, 87

Conjunctiva, noninfectious scleri­tis, 148

Conjunctival vessel, transmission electron microscopy, 22-23

Conjunctivitis, Reiter's syn­drome, 201

Connective tissue immune response, 46-47 inflammation, 137-139 noninfectious scleritis, 155-157

Cornea noninfectious scleritis, 148 physical examination, 73

Corneoscleral junction, 11-12 Corticosteroids, 303, 304 Crohn's disease, 205-207

anterior uveitis, 206 diagnosis, 207 epidemiology, 205 episcleritis, 207 keratitis, 207 laboratory findings, 207 noninfectious scleritis, 206-257 ocular manifestations, 206-207 radiological findings, 207 systemic manifestations, 205

Cyclosporine, 304 Cystinosis, 280-281

Deep episcleral plexus, 14, 15, 16 Dense connective tissue tumor,

289-292 Dermoid choristoma, 289 Diffuse anterior scleritis, 104 Diffuse scleritis, biopsy, 163-

164 Disk edema

posterior scleritis, 124 scleritis, 115

Ehlers-Danlos syndrome, 286 Elastase, 27 Elastin, 23, 25 Elderly patient, 9 Emissary canal, 14-20

fibrils, 21

Eosinophil, 39 secretory products, 39

Episclera anatomy, 13

Index

noninfectious scleritis, 148 physical examination, 68-71

Episcleral vessel, transmission electron microscopy, 22-23

Episcleritis, 69, 80, 95-102 anterior segment fluorescein

angiography, 82-86 anterior uveitis, 98, 99 associated diseases, 60, 72, 100 Beh~et's disease, 218 bilaterality, 97, 98 biopsy, 88-89 blood test, 74-81 cataract, 99 classification, 60, 96, 99-100 clinical manifestations, 97-99 Cogan's syndrome, 222 computerized tomography, 87 Crohn's disease, 207 diagnosis, 59-90 diagnostic tests, 74-88 family history, 62 functional tests, 80 glaucoma, 99 head and extremity examina-

tion, 64 herpes simplex scleritis, 264-265 herpes zoster scleritis, 261-262 history of present illness, 60-62 infectious scleritis, 253 magnetic resonance imaging,

87-88 major complaint, 60-62 past history, 62 pathology, 141 patient characteristics, 96-97 physical examination, 65-74 polyarteritis nodosa, 211 precipitating factors, 102 psoriatic arthritis, 204 quantitation tests, 80 Reiter's syndrome, 201-202 relapsing polychondritis, 209 rheumatoid arthritis, 185 scleritis, interrelationship, 98 simple, 99 skin testing, 81 syphilis, 250-251 systemic lupus erythematosus,

191

Index

systems questionnaire, 63-64 systems review, 62-65 therapeutic plan, 89 therapy history, 62 treatment, 299-300 ulcerative colitis, 207 ultrasonography, 86-87 visual acuity, 72-73, 98 Wegener's granulomatosis,

214-215 Epithelial tumor, 289 Epstein-Barr virus, rheumatoid

arthritis, 49 Extracellular matrix, noninfec­

tious scleritis, 144-146 Extraocular muscle, physical ex­

amination, 73 Eye, physical examination, 71-

74 external by daylight, 69-70 slit-lamp, 70-71

Familial hypercholesterolemia, 281-282

Felty's syndrome, 179 Fibrinoid necrosis, 138-139 Fibroblast, 21-22

growth regulation, 27 immune response, 46-47 prostaglandin, 47

Fibroblast growth factor, 27 Fibroma, 290 Fibronectin, 24, 26 Fibrous histiocytoma, 290 Fluorescein angiography, poste-

rior scleritis, 118-120 Foreign body, 225-226 Fundus

physical examination, 74 scleritis, 115

Fungal scleritis, 255-258 management, 255-257 organisms, 255 pathogenesis, 255

Giant cell arteritis, 218-221 diagnosis, 220-221 epidemiology, 219 laboratory findings, 220 noninfectious scleritis, 220 ocular manifestations, 219-

220 systemic manifestations, 219

Glaucoma, 129-130. See also Spe-cific type

episcleritis, 99 rheumatoid arthritis, 184 scleritis, 99

Globe, vascular supply, 17 Glycoprotein, 9, 24, 26-27

fetal sclera, 9 noninfectious scleritis, 146

Glycoproteinase, 27 Glycosaminoglycan, 8, 25-26

rheumatoid arthritis, 50 scleritis, 50

Gout, noninfectious scleritis, 225

Gram-negative rod scleritis, 243-246

management, 243-245 organisms, 243 pathogenesis, 243 prognosis, 245

Gram-positive coccus scleritis, 243-246

management, 243-245 organisms, 243 pathogenesis, 243 prognosis, 245

Granuloma, necrotizing scleritis, 143

Head, physical examination, 65-67

Heart rheumatoid arthritis, 177-178 systemic lupus erythematosus,

190 Helminthic scleritis, toxocariasis,

268-269 Hemangioma, 290 Herpes simplex scleritis, 263-

265 clinical features, 264-265 diagnosis, 265 epidemiology, 263 episcleritis, 264-265 infectious scleritis, 158-159,

264 pathogenesis, 263-264 therapy, 265

Herpes zoster scleritis, 258-263 clinical features, 259-260 diagnosis, 262 epidemiology, 259 episcleritis, 261-262

infectious scleritis, 157-158, 260-261

pathogenesis, 259 treatment, 262-263

Histiocytosis X, 281-282 HLA-B27

311

ankylosing spondylitis, 42 Reiter's disease, 42

HLA-DRw4, rheumatoid arthri­tis, 42

HLA typing, 80 Hyaluronic acid, immune re-

sponse, 47 Hypercalcemia, 282-283 Hyperparathyroidism, 282 Hypersensitivity reaction, im-

mune response, 43-45 Arthus reaction, 44 local immune complex disease,

44 systemic immune complex dis­

ease, 43-44 type III, 43 type IV, 44-45

Idiopathic central serous chorio­retinopathy, differential diagnosis, 120

Idiotypic regulation, antibody, 42 Immune complex, vessel wall, 141 Immune complex-mediated vascu-

litis, 51 Immune response, 33-46

abnormalities, 43-46 autoimmunity, 45-46

mechanisms, 46 cellular mechanisms, 42 collagen, 47 collagenase, 47 components, 34-40 connective tissue, 46-47 fibroblast, 46-47 humoral mechanisms, 42 hyaluronic acid, 47 hypersensitivity reaction, 43-45

Arthus reaction, 44 local immune complex dis­

ease, 44 systemic immune complex

disease, 43-44 type III, 43 type IV, 44-45

sclera, 47-52 Immunoregulation, 41-43

312

Immunosuppressive, therapy, 301

Infectious scleritis, 242-269. See also Specific type

biopsy, 163-164 classification of organisms

causing, 242 clinicopathological correlates,

157-161 episcleritis, 253 herpes simplex scleritis, 158-

159,264 herpes zoster scleritis, 157-158,

260-261 local infections, 160-161 Lyme disease, 253 syphilis, 159-160,250-251 systemic infections, 157-160 treatment, 304 tuberculosis, 159

Inferior oblique muscle, inser-tion, 10, 11

Inferior ophthalmic vein, 19 Inferior vortex vein, 18 Inflammatory bowel disease-

associated arthritis, 205-207

Inflammatory microangiopathy, 88-89, 140-141, 146

Internal carotid artery, 17 Intraepithelial epithelioma, 289 Intraocular pressure, physical ex-

amination, 74 Intrascleral nerve loop of Axen­

feld,20 Iris

major arterial circle, 18 noninfectious scleritis, 148

Iron deficiency anemia, 287

Jaundice, 283 Juvenile rheumatoid arthritis,

223

Keratitis Crohn's disease, 207 rheumatoid arthritis, 183 ulcerative colitis, 207

Keratoconjunctivitis, rheumatoid arthritis, 180-181

Keratoconus, 286 Keratopathy, scleritis, 125-130 Killer cell, 36

Lacrimal artery, 17 Lacrimal vein, 19 Lamina fusca, anatomy, 14 Laminin, 26-27 Langerhans' cell, 38 Larynx, rheumatoid arthritis, 179 Lens, physical examination, 74 Lens placode

fourth week of development, 2,3

sixteenth week of development, 6-7

Leprosy, mycobacterial scleritis, 248-249

Leukemia,291 Lid swelling, posterior scleritis,

121-122 Limbal arcade, 14 Limbal venous circle, 14, 15 Long posterior ciliary artery, 17,

19 Lung

rheumatoid arthritis, 176-177 systemic lupus erythematosus,

190 Lyme disease, 253-254

clinical features, 253 diagnosis, 254 epidemiology, 253 infectious scleritis, 253 pathogenesis, 253 treatment, 254

Lymph node, rheumatoid arthri-tis, 179

Lymphangioma, 290 Lymphocyte, 34-36 Lymphoma, 291 Lymphosarcoma, 291

~acrophage,36-38

secretory products, 37 Macular edema, posterior scleri­

tis, 124 Magnetic resonance imaging

episcleritis, 87-88 scleritis, 87-88

Major histocompatibility com­plex,41

Marfan syndrome, 284 Marie-Striimpell disease. See An­

kylosing spondylitis Mast cell, 39-40

secretory products, 40 subtype differences, 40

Index

Matrix-degrading enzyme, 27 Melanocytoma, 292 Mesoderm, embryology, 4 Methotrexate, 302 Monocyte, 36-38 Mucopolysaccharidosis, 282 Mumps scleritis, 266 Muscular edema, scleritis, 115 Mycobacteria, rheumatoid arthri-

tis, 49 Mycobacterial scleritis, 246-249

atypical mycobacterial disease, 246-247

leprosy, 248-249 tuberculosis, 247-248

Myopia, 287

Nanophthalmos, 288 Natural killer cell, 36 Necrotizing anterior scleritis

with inflammation. See Necro­tizing scleritis

without inflammation. See Scleromalacia perforans

Necrotizing scleritis, 70, 71, 107, 108-111

after ocular surgery, 130, 131 biopsy, 142, 143 collagen, 50 granuloma, 143 inflammation, 111 pathogenesis, 51 rheumatoid arthritis, 183, 184 treatment, 301 vasculitic finger lesion, 67 vessels, 146-147

Neovascular glaucoma, 130 Nervous system

rheumatoid arthritis, 178-179 systemic lupus erythematosus,

190 Nervous tissue tumor, 291 Neural crest, embryology, 4 Neurilemoma, 291 Neuroectoderm, embryology, 4 Neurofibroma, 291 Neutrophil, 38

secretory products, 39 Nevus, 292 Nocardiosis, 253-254 Nodular anterior scleritis, 107-

108 Nodular episcleritis, 100 Nodular fasciitis, 289-290

Index

Nodular scleritis, 107, 605 biopsy, 163-164

Noninfectious necrotizing scleri­tis, biopsy, 161-162

Noninfectious recurrent diffuse scleritis, biopsy, 162

Noninfectious recurrent nodular scleritis, biopsy, 162

Noninfectious recurrent nonnec­rotizing scleritis, biopsy, 162

Noninfectious scleritis, 171-227 allergic granulomatous angiitis,

151 ankylosing spondylitis, 197-

198 Beh~et's disease, 217-218 chemical injury, 226 choroid, 148 Churg-Strauss syndrome, 151 ciliary body, 148 Cogan's syndrome, 221-222 conjunctiva, 148 connective tissue disease, 155-

157 cornea, 148 Crohn's disease, 206-257 dermatological disease-

associated, 224-225 episclera, 148 extracellular matrix, 144-146 foreign body granuloma-

associated,225-226 giant cell arteritis, 220 glycoprotein, 146 gout, 225 iris, 148 metabolic disease-associated,

225 pathology, 141-161 polyarteritis nodosa, 149-151,

210-211 proteoglycan, 145-146 psoriatic arthritis, 204 Reiter's syndrome, 201 relapsing polychondritis, 209 rheumatoid arthritis, 155-157,

181-185 incidence, 181, 182

rosacea, 224-225 sclera, 141-144 systemic lupus erythematosus,

191 systemic vasculitic disease,

149-157

ulcerative colitis, 206-257 Wegener's granulomatosis,

151-155,214 Nonsteroidal antiinflammatory

drug,299-300 polyarteritis nodosa, 300-301 Wegener's granulomatosis,

300-301 Nuclear antigen, antibody, 76 Null lymphocyte, 36

Ocular examination, physical ex­amination, 67-74

Ocular movement limitation, pos-terior scleritis, 121-122

Ocular structure, embryology, 4 Open-angle glaucoma, 129-130 Optic nerve, 12, 13 Orbital tumor, differential diag­

nosis, 118 Osteogenesis imperfecta, 284-285

Papilloma, 289 Paralimbic scleromalacia, 111-

112, 287-288 Parasitic scleritis, 266 Parvovirus, rheumatoid arthritis,

49 Pellucid marginal degeneration,

differential diagnosis, 126 Peripheral corneal thinning, 125

differential diagnosis, 126 Peripheral ulcerative keratitis, 72,

127-128, 150, 157 cyclophosphamide, 110 rheumatoid arthritis, 183, 184

Periungal infarct, 156 rheumatoid vasculitis, 67 vasculitic finger lesion, 67

Phagocytosis, 37-38 Phthisis bulbi, 288 Physical examination

anterior uvea, 73-74 cornea, 73 episclera, 68-71 extraocular muscle, 73 extremities, 67 eye, 71-74

external by daylight, 69-70 slit-lamp, 70-71

fundus, 74 head,65-67 intraocular pressure, 74

lens, 74 ocular examination, 67-74 pupil, 73 sclera, 68-71

Pigmented tumor, 292 Platelet, 40

secretory products, 41 Polyarteritis nodosa, 209-211

angiographic findings, 211 diagnosis, 211 epidemiology, 210 episcleritis, 211 laboratory findings, 211 noninfectious scleritis, 149-

151,210-211

313

nonsteroidal antiinflammatory drug,300-301

ocular manifestations, 210-211 systemic manifestations, 210 treatment, 301, 303

Polymyalia rheumatica, 219 Polymorphonuclear granulocyte,

38-40 Porphyria,278-280 Posterior ciliary artery, 16-17, 18 Posterior ciliary nerve, 20 Posterior ciliary vein, 18 Posterior scleral foramen, anat-

omy, 12-13 Posterior scleritis, 112-124

annular ciliochoroidal detach-ment, 115-116, 123-124

associated diseases, 115-116 chemosis, 121-122 choroidal fold, 123 complications, 116 computerized tomography, 117 differential diagnosis, 118,

120-124 disk edema, 124 external signs, 113-114 fluorescein angiography, 118-

120 initial site, 113-114 initial symptoms, 113-114 lid swelling, 121-122 macular edema, 124 ocular movement limitation,

121-122 proptosis, 121-122 radioactive phosphorus uptake,

118 serous retinal detachment, 115-

116, 123-124 subretinal mass, 122-123

314

Posterior scleritis (cont.) treatment, 304 ultrasonography, 116-117 visual acuity, 114

Proptosis, posterior scleritis, 121-122

Prostaglandin, fibroblast, 47 Proteoglycan, 8, 23-24, 25-26

fetal sclera, 8 noninfectious scleritis, 145-146

Proteoglycanase,27 Protozoal scleritis, 266-268

Acanthamoeba, 266-267 toxoplasmosis, 267-268

Pseudoxanthoma elasticum, 285-286

Psoriatic arthritis, 203-205 articular involvement, 203-204 diagnosis, 204-205 epidemiology, 203 episcleritis, 204 laboratory findings, 204 noninfectious scleritis, 204 ocular manifestations, 204 radiographic findings, 204 skin involvement, 203-204 systemic manifestations, 203-

204 Pupil, physical examination, 73

Radioactive phosphorus uptake, posterior scleritis, 118

Raji cell-binding assay, 79 Rash, systemic lupus erythemato­

sus, 66 Receptor cross-linking, antibody,

42 Rectus muscle, insertion, 10 Reiter's syndrome, 198-202

anterior uveitis, 201 articular involvement, 199 conjunctivitis, 201 diagnosis, 202 epidemiology, 199 episcleritis, 201-202 extraarticular systemic manifes-

tations, 199-201 HLA-B27,42 laboratory findings, 202 noninfectious scleritis, 201 ocular manifestations, 201 radiographic findings, 202 systemic manifestations, 199-

201

Relapsing polychondritis, 207-209

diagnosis, 65, 209 epidemiology, 208 episcleritis, 209 laboratory findings, 209 noninfectious scleritis, 209 ocular manifestations, 208-209 systemic manifestations, 208 treatment, 301, 303

Rheumatoid arthritis, 72, 172-188

acute-phase reactants, 186 anterior uveitis, 183-184 anti-nuclear antibodies, 187 cataract, 184 choroidal changes, 184 circulating immune complex,

186-187 collagen, 50 complement, 187 complete blood count, 186 cryoglobulins, 187 diagnosis, 187-188 endogenous substances, 49-50 epidemiology, 173 episcleritis, 185 Epstein-Barr virus, 49 exogenous agents, 48-49 extraarticular systemic manifes-

tations, 174-180 glaucoma, 184 glycosaminoglycan, 50 heart, 177-178 HLA-DRw4, 42 keratitis, 183 keratoconjunctivitis, 180-181 laboratory findings, 185-187 larynx, 179 lung, 176-177 lymph node, 179 motility disturbances, 184-185 mycobacteria, 49 necrotizing scleritis, 183, 184 nervous system, 178-179 noninfectious scleritis, 155-

157, 181-185 incidence, 181, 182

ocular manifestations, 180-185 onset, 175 optic nerve changes, 184 parvovirus, 49 peripheral ulcerative keratitis,

183,184 radiographic evaluation, 187

retinal changes, 184 scleritis, 50

incidence, 181, 182

Index

signs and symptoms, 173-174 synovial fluid analysis, 186 systemic manifestation, 175-

180 tegument, 175 treatment, 301-302 vessels, 175-176 virus, 48-49

Rheumatoid factor, 74-76, 185-186

associated diseases, 75 Rheumatoid spondylitis. See An­

kylosing spondylitis Rheumatoid vasculitis

periungal infarct, 67 subcutaneous nodules, 68 vasculitic finger lesion, 67

Rosacea, noninfectious scleritis, 224-225

Sarcoidosis, 223 Sarcoma, 290 Sceral foramen, anatomy, 10-12 Schwannoma, 291 Sclera

age-related changes, 9 anatomy, 10-23 biochemistry,23-24 biomechanics,24-25 blood supply, 14-20 circulatory dynamics, 20 development, 1-9 embryology, 4 emissary canals, 14-20 functions, 1 immune response, 47-52 immunohistochemistry, 24 immunology, 33-52 layers, 13-14 molecular structure, 25-27 nerve supply, 20 noninfectious scleritis, 141-144 noninflammatory diseases,

278-293 physical examination, 68-71 postnatal development, 9 prenatal development

immunohistochemical stud­ies, 7-9

ultrastructural studies, 1-7 structural aspects, 1-28

Index

ultramicroscopic anatomy, 20-22

vascular distribution, 14-20 water content, 24

Scleral carbohydrate deposition, 282

Scleral deposit, 278-283. See also Specific type

Scleral distensibility, 24-25 Scleral granuloma, cellular infll­

trates, 142 Scleral lipid deposition, 281-282

age-related, 282 Scleral loss, differential diagno­

sis, 112 Scleral mineral deposition, cal­

cium, 282-283 age-related, 283

Scleral nodule, 605 Scleral pigment deposition, biliru­

bin, 283 Scleral protein deposition, 278-

281 Scleral stroma, anatomy, 13-14 Scleral thickening, 288 Scleral thinning, 283-288 Scleral tissue inflammation, 139-

161 Scleral tumor, 288-292

secondary, 292 Scleritis, 33, 47-52, 80. See also

Specific type ancillary therapy, 304 anterior segment fluorescein

angiography, 82-86 anterior uveitis, 98, 99 associated diseases, 60, 72, 106,

124-125 associated immune-mediated

diseases, 172-224 associated noninfectious dis­

eases, 171, 172 associated vasculitic syn-

dromes, 149-157 bilaterality, 97, 98 biopsy, 88-89 blood test, 74-81 cataract, 99 cell subsets, 144 choroidal fold, 115 classification, 60, 96, 104-

124 clinical manifestations, 103-

104 collagen, 50

complications, 125-130 diagnosis, 59-90 diagnostic tests, 74-88 disk edema, 115 drug management, 304-305 endogenous substances, 49-50 episcleritis, interrelationship,

98 etiology, 48-50 exogenous agents, 48-49 family history, 62 fundus, 115 glaucoma, 99 glycosaminoglycan, 50 head and extremity examina-

tion, 64 histopathology, 143 history of present illness, 60-62 immunogenetics, 48 incidence, 96 keratopathy, 125-130 magnetic resonance imaging,

87-88 major complaint, 60-62 medical treatment, 300-304 muscular edema, 115 past history, 62 pathogenesis, 33, 48, 50-52 pathology, 137-164 patient characteristics, 103 physical examination, 65-74 quantitation tests, 80 radiological studies, 81-82 rheumatoid arthritis, 50

incidence, 181, 182 skin testing, 81 subretinal mass, 115 surgical treatment, 305-307 susceptible host, 48 systems questionnaire, 63-64 systems review, 62-65 therapeutic plan, 89 therapy history, 62 ultrasonography, 86-87 vasculitides, 172-224 visual acuity, 72-73, 98

Scleromalacia perforans, 111-112

differential diagnosis, 111-112 Scleropachynsis, 288 Senile furrow degeneration, dif­

ferential diagnosis, 126 Senile scleral hyaline plaque, 112,

283 Senile scleral plaque, 71

315

Serous retinal detachment, poste­rior scleritis, 115-116, 123-124

Short posterior ciliary artery, 17, 19

Short posterior ciliary vein, 19 Skin testing

episcleritis, 81 scleritis, 81

Slit-lamp examination, 70-71 diffuse illumination, 70-71 red-free illumination, 71 white illumination, 71, 72

Spiral of Tillaux, 10 Spirochetal scleritis, 249-254 Squamous cell carcinoma, 289 Stromal keratitis, 127 Subretinal mass

posterior scleritis, 122-123 scleritis, 115

Superficial episclera plexus, 14, 16

Superior oblique muscle, inser-tion, 10, 11

Superior ophthalmic vein, 19 Superior vortex vein, 18 Supraorbital ophthalmic vein, 19 Surface ectoderm, embryology, 4 Syphilis, 250-252

clinical features, 250 diagnosis, 251-252 epidemiology, 250 episcleritis, 250-251 infectious scleritis, 159-160,

250-251 pathogenesis, 250 therapy, 252

Systemic immune-mediated dis­ease-associated scleritis, after ocular surgery, 223-224

Systemic lupus erythematosus, 188-193

diagnosis, 193, 194 epidemiology, 188 episcleritis, 191 heart, 190 kidney, 189-190 laboratory findings, 192-193 lung, 190 musculoskeletal problems, 188 nervous system, 190 noninfectious scleritis, 191 ocular involvement, 191-192 rash,66

316

Systemic lupus erythematosus (cont.)

systemic manifestations, 188-191

tegument, 188-189 treatment, 301, 302-303 vessels, 189

Systemic vasculitic disease, non­infectious scleritis, 149-157

T lymphocyte, 35-36 Terrien's marginal degeneration,

126 differential diagnosis, 126

Third population lymphocyte, 36

Thyroid ophthalmopathy, differ­ential diagnosis, 118

Toxocariasis, helminthic scleritis, 268-269

Toxoplasmosis, protozoal scleri­tis, 267-268

Tuberculosis infectious scleritis, 159 mycobacterial scleritis, 247-

248

Ulcerative colitis, 205-207 anterior uveitis, 206 diagnosis, 207 epidemiology, 205 episcleritis, 207 keratitis, 207 laboratory findings, 207 noninfectious scleritis, 206-257 ocular manifestations, 206-207 radiological findings, 207 systemic manifestations, 205

Ultrasonography episcleritis, 86-87 posterior scleritis, 116-117 scleritis, 86-87

Uveal effusion syndrome, differ­ential diagnosis, 120

Uveitis, 128-129

Vascular cast, 15, 16 Vascular inflammation, 139 Vascular tumor, 290 Vasculitic finger lesion

necrotizing scleritis, 67 periungal infarct, 67 rheumatoid vasculitis, 67

Vasculitis, 139-140

Index

Vessel wall, immune complex, 141

Viral scleritis, 258-266 Virus, rheumatoid arthritis, 48-49 Visual acuity

episcleritis, 72-73, 98 posterior scleritis, 114 scleritis, 72-73, 98

Vitronectin, 24 Vogt-Koyanagi-Harada syn­

drome, 223 differential diagnosis, 120

Vortex vein, 17, 18, 19

Wegener's granulomatosis, 212-216

clinical manifestations, 213 diagnosis, 213, 215-216 epidemiology, 213 episcleritis, 214-215 laboratory findings, 215 noninfectious scleritis, 151-

155,214 nonsteroidal antiinflammatory

drug,300-301 ocular manifestations, 213-215 treatment, 301, 303