- Reza Dana, MD, MPH, MSc
Reza Dana, MD, MPH, MSc
- Claes Dohlman Professor of Ophthalmology
- Harvard Medical School
Episcleritis is defined by the abrupt onset of inflammation in the episclera of the eye. Most patients with episcleritis have a mild, isolated problem that responds readily to topical therapy alone and does not pose a threat to vision. Indeed, many patients with episcleritis require no treatment per se since the condition typically resolves over a short course. A small fraction of patients with episcleritis have an underlying systemic disease that signifies a serious health concern and that requires additional therapy.
Episcleritis is only one of many potential causes of a red eye. Other disorders that may cause this syndrome include subconjunctival hemorrhage, conjunctivitis, blepharitis, keratitis, scleritis, acute anterior uveitis, and acute angle-closure glaucoma. (See "Evaluation of the red eye".)
Issues related to episcleritis will be reviewed here. The clinical manifestations, diagnosis, and treatment of scleritis are discussed separately. (See "Clinical manifestations and diagnosis of scleritis" and "Treatment of scleritis".)
Approximately 70 percent of cases of episcleritis occur in females . It occurs most frequently in young and middle-aged adults, but may affect all age groups.
Episcleritis is usually classified as either simple or nodular (picture 1 and picture 2). Simple episcleritis is usually sectoral in nature, confined to a carefully delimited portion of the episclera. However, more diffuse episcleral involvement can occur.
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- CLINICAL FEATURES
- Distinguishing episcleritis from scleritis
- Distinguishing episcleritis from conjunctivitis
- Distinguishing episcleritis from herpes keratitis
- Systemic disease associations
- Basic tests
- Specialized serologic assays
- Chest imaging
- Other testing
- Topical lubricants
- Topical NSAIDs
- Topical glucocorticoids
- Oral NSAIDs
- SUMMARY AND RECOMMENDATIONS
- Clinical features