Episcleritis: Difference between revisions
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==Work-Up== | ==Work-Up== | ||
* Must distinguish from [[scleritis]] | * 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]] | * Must distinguish from [[conjunctivitis]] | ||
** | **Episcleritis will usually have a sectoral pattern of injection, as opposed to a diffuse injection seen in conjunctivitis. | ||
==DDx== | ==DDx== |
Revision as of 06:54, 1 May 2015
Background
- Abrupt onset of inflammation in the episclera
- 70% of cases occurs in women (usually young and middle-aged)
- Usually a benign, self-limited condition
- Usually not associated with an underlying disease
Diagnosis
- History
- Abrupt onset of redness, irritation, and watering of the eye
- Pain is unusual
- Vision unaffected
- 50% of cases are bilateral
- Physical
- Vasodilatation of the superficial episcleral vessels
- Focal area(s) of redness
- May have a tender scleral nodule (nodular episcleritis)
Work-Up
- 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.
DDx
- Scleritis
- Conjunctivitis
- Herpes Keratitis
Treatment
- Topical lubricants
- Artificial tears q4-6hr
- Oral NSAIDs
Disposition
Refer to ophtho to reduce chance of misdiagnosis
Prognosis
Self-limiting (will resolve within 2-3 weeks)
See Also
Source
UpToDate