American Board of Internal Medicine (ABIM) Certification Practice Exam

What condition is characterized by painful inflammation of the fibrous layers of the eye?

1. Conjunctivitis

2. Scleritis

3. Uveitis

4. Keratitis

The correct answer is: Scleritis

The condition characterized by painful inflammation of the fibrous layers of the eye is scleritis. Scleritis specifically refers to the inflammation of the sclera, which is the white outer coating of the eyeball. This condition can cause significant pain and discomfort, often described as deep, aching pain that may radiate to other areas such as the forehead or jaw. Scleritis is often associated with systemic diseases, such as rheumatoid arthritis or other autoimmune disorders, and can lead to complications such as vision loss if not treated adequately. The inflammation in scleritis can significantly affect the integrity of the eye and the overall visual function. While conjunctivitis involves inflammation of the conjunctiva and typically presents with redness, tearing, and discharge, it is usually not painful. Uveitis, on the other hand, involves inflammation of the uveal tract and can also cause pain and visual disturbances, though it is generally less focused on the fibrous layers than scleritis. Keratitis refers to inflammation of the cornea and can lead to pain and visual impairment, but its focus is more posterior to the sclera itself. Understanding the specific features of these ocular conditions helps differentiate scleritis from other forms of eye inflammation, leading to a more accurate diagnosis and