Episcleritis
Revision as of 00:18, 16 June 2015 by Neil.m.young (talk | contribs)
Background
- Abrupt onset of inflammation in the episclera
- 70% of cases occurs in women (usually young/middle-aged)
- Usually a benign, self-limited condition
- Can be classified into simple (more common) or nodular types
- Most commonly idiopathic but may occur as an ocular manifestation of underlying autoimmune conditions eg RA, IBD
Clinical Features
- History
- Abrupt onset of redness, irritation, and watering of the eye
- Pain is unusual
- Vision unaffected
- 50% of cases are bilateral
- Physical exam
- Vasodilatation of the superficial episcleral vessels
- Focal area(s) of redness
- May have a tender scleral nodule (nodular episcleritis)
Differential Diagnosis
Diagnosis
- Must distinguish from scleritis
- Scleritis likely to have pain and decreased vision
- Use of 2.5% phenylephrine drops will cause vasoconstriction/blanching of episcleral but not scleral vessels. Thus, there will be decreased injection and redness in episcleritis but not scleritis.
- Must distinguish from conjunctivitis
- Episcleritis will usually have a sectoral pattern of injection, as opposed to a diffuse injection seen in conjunctivitis.
Management
- Topical lubricants
- Artificial tears q4-6hr
- Oral NSAIDs
Disposition
- Refer to ophtho is unsure of diagnosis or if steroids are necessary for Tx
- Self-limiting (will resolve within 2-3 weeks)
See Also
External Links
References
UpToDate