P1: OXT/OZN/JDO P2: PSB
0521779407-E-01 CUNY1086/Karliner 0 521 77940 7 June 4, 2007 21:10
Episcleritis and Scleritis Erectile Dysfunction 539specific therapy
Indications
■Scleritis: always
■Episcleritis that significantly interferes with daily life (eg, someone
in public eye)
Treatment Options
■Oral NSAIDs: OTC for episcleritis, Cox-2 specific NSAID, nonspecific
NSAID
■Steroid: systemic
■Immunomodulators: methotrexate, azathioprine, mycophenolate
mofteil,cyclophosphamide
■N.B. disease-specific to some extent: eg, cyclophosphamide treat-
ment of choice for polyarteritis nodosa, Wegener granulomatosis,
and necrotizing scleritis secondary to rheumatoid arthritis or relaps-
ing polychondritis
follow-up
During Treatment
■Every 1 to 4 weeks, depending upon response and drug employed
Routine
■For episcleritis: yearly
■For scleritis: every 3 months
complications and prognosis
■Episcleritis
➣transition to true scleritis (10%)
➣Scleritis peripheral keratitis 25% peripheral ulcerative keratitis
15%
➣uveitis 42%
➣cataract 17%
➣loss of vision 37%Erectile Dysfunction..................................
SHAHRAM S. GHOLAMI, MD; WILLIAM O. BRANT, MD;
ANTHONY J. BELLA, MD; MAURICE M. GARCIA, MD; and TOM F. LUE, MD
history & physical
Definition: Inability to achieve and maintain an erection sufficient for
satisfactory sexual intercourse