Two major forms are recognised. Necrotising scleritis or brawny scleritis is the most severe form and is characterised by severe inflammation and pain. Necrosis results in thinning of the sclera. It may remain localised or may spread to involve the entire anterior sclera.
Necrotising scleromalacia or scleromalacia perforans effectively lacks any painful or inflammatory component. It is rare and is most often associated with rheumatoid arthritis. Scleral thinning occurs as in necrotising scleritis and may lead to bulging.
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