The fibrous sclera is the protective outer layer of the eye and the insertion site of the external eye muscles. Its thickness varies with age and location, the posterior sclera being thickest. It has to withstand normal intraocular pressure unchanged. Glaucoma (especially in children) as well as hypotony results in scleral changes (see chapter on glaucoma and trauma). Congenital disorders are blue sclera, staphylomas, and high axial myopia. Surgical as well as accidental injuries of the sclera are common (see chapters on trauma). A rare but serious disease is scleritis, which is often associated with collagen diseases such as rheumatoid arthritis or Wegener’s granulomatosis. A frequently encountered degenerative lesion is the age-related (senile) scleral plaque found anterior to the insertion of the horizontal recti in the elderly. Calcification and ossification of degenerative scleral collagen may occur.
KeywordsArthritis Retina Glaucoma Cataract Dial
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