Episcleritis

Episcleritis is a benign, self-limiting inflammatory disease affecting the episclera, the loose connective tissue between the conjunctiva and sclera, causing mild discomfort. It is usually idiopathic and only rarely associated with systemic disease (e.g. rheumatoid arthritis).

Symptoms

  • Mild ache / soreness of the eye
  • Eye is mildly tender to touch
  • Red eye 

Signs

  • Segmental or focal redness which may can be raised (nodular)
  • Redness disappears on compression and redness mobile on white of the eye with cotton bud – redness is nether mobile or compressible in scleritis 

Eye examination

  • Observe conjunctiva and cornea with white light
  • Instil 1 drop of proxymetacaine 0.5% with fluorescein 0.25%
  • Observe for corneal staining preferably using a blue light
  • You may wish to use a cotton bud to compress and move the red area 

Treatment

  • Give patient episcleritis information leaflet
  • Inform patient that the cause of episcleritis is unknown and that although symptoms are uncomfortable, the condition is usually self-limiting and not harmful
  • Oral anti-inflammatories such as ibuprofen will help with the discomfort of episcleritis
  • Artificial tears, which can be bought over the counter, will help keep the eye comfortable
  • Review as appropriate