The Association Between Mental Health Disorders and Non-Infectious Scleritis: A Prevalence Study and Review of the Literature

Chronic inflammatory diseases can cause significant psychosocial stress in affected patients. Few studies have examined the psychological effects of ocular inflammatory disease and no studies have examined the psychological effects of scleritis. In this study we evaluate the prevalence of mental health disorders in scleritis patients and we conduct a comprehensive review of the literature on the mental health effects of ocular inflammatory diseases. 162 patients (195 eyes) presenting to a tertiary care center with scleritis were identified. At least one comorbid mental health disorder was diagnosed in 35 patients (21.6%), most commonly major depression in 11.7%, generalized anxiety disorder in 9.3%, and substance use disorder in 6.2%. There were no significant differences in the length of an episode of scleritis or in the probability of symptom resolution between patients with a mental health disorder and other patients. In a review of the literature, 30 manuscripts met the inclusion criteria. The majority of manuscripts (83.3%) were focused on uveitis patients. Eight of these studies were focused on patients with uveitis in the context of systemic disease. The most commonly reported mental health disorders reported were anxiety and depression. An average of 31.3% of patients with ocular inflammatory disease had depression and 35.0% had anxiety. Similar to other chronic illnesses, ocular inflammatory disease may be a significant psychosocial stressor. Future studies will further elucidate the relationship between these diseases and mental health.

Management of Intraocular Inflammatory Disease

Background: Intra ocular inflammatory disease is a broad-spectrum eye inflammatory condition. Objective: To evaluate various management protocols for Intra ocular inflammatory disease. Study Design: Retrospective study Place and Duration of Study: Department of Ophthalmology, Lorallai Medical College, Loralai from 1st January 2020 to 31st March 2021. Methodology: One hundred and twenty medical files of patients with various intra ocular inflammatory diseases were recruited. Patients were managed by various pharmacological drugs including corticosteroids, second line agents, anti-metabolites as well as biologics (anti-TNF-alpha) therapy. Results: There were 45% females while 55% were males. The mean age of the patients was 45±4.4 years. Majority of the patients were within 41-50 years with 37.5% followed by those >50 years of age. Corticosteroids were efficient in 50% of patients with intra ocular inflammatory disease as a secondary condition while azathioprine in 75% patient and tacrolimus 93.4% patients. Conclusion: Second line agents and antimetabolites have higher prevalence of acceptance and efficacy in managing intra ocular inflammatory disease. Keywords: Management, Intraocular inflammatory disease, Broad spectrum