Anatomy
The Sclera: Your Eye's Protective White Shell
The sclera is the tough, white outer coat of the eye. It covers about 85% of the eye's surface and provides structural protection, maintaining the eye's shape and acting as an anchor for the muscles that move the eye. Conditions like episcleritis and scleritis can cause painful redness in the sclera.
Anatomy Overview
The Sclera: Your Eye's Protective White Shell
Structure & Components
Redness and tenderness (episcleritis — superficial, usually benign)
Deep, boring pain and photophobia (scleritis — more serious)
Scleral thinning visible as blue-grey area (scleritis or post-surgical)
Yellow-white raised deposits (hyaline degeneration with aging)
Blue sclera in osteogenesis imperfecta (collagen disorder)
Visible scleral vessels during conjunctival or scleral inflammation
Functions & Physiology
Dense collagen fibre network gives sclera its strength and white colour
Tendons of six extraocular muscles insert into the sclera
Episcleritis: superficial inflammation often linked to autoimmune disease
Scleritis: deep inflammation associated with rheumatoid arthritis, lupus, or vasculitis
Scleral perforation possible from severe infection or trauma
Staphyloma: bulging of weakened sclera from long-standing glaucoma or myopia
Key Points
Episcleritis: usually self-limiting; cold compresses and NSAIDs
Scleritis: systemic NSAIDs, corticosteroids, or immunosuppressants
Rheumatological work-up if scleritis is recurrent
Surgical scleral patch graft for severe thinning or perforation
Anti-infective treatment if scleral infection (scleritis post-surgery)
Regular monitoring of scleral health in high myopes
Scleral lenses (contact lenses that vault the sclera) for irregular corneas
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