4 - Opth - Acute red eye - Episcleritis and Scleritis

Question 1

what is episcleritis?
often what?
most common in?
may be..?

Answer 1

inflammation of episclera below conjunctiva
often recurrent
most common in young women
may be bilateral

Question 2

Sx episcleritits

Answer 2

acute onset
often aSx
dull ache OR gritty/pin prick sensation, eye watering and photophobia

Question 3

Signs Episcleritis

Answer 3

• localised redness in sector of eye
• translucent white infl nodule may be visible
• VA unaffected

Question 4

Causes episcleritis

Answer 4

idiopathic 70%

Systemic disease associations –> IBD, RA, SLE

Question 5

Mgmt episcleritis

Answer 5

usually self limiting
artificial tears

NSAID/corticosteroid drops if severe

Question 6

What is scleritis?
may progress to?
% of cases ass w/ systemic disease?

Answer 6

inflammation through whole thickness of sclera

may progress to necrosis and perforation in severe cases

50% ass w systemic disease

Question 7

Systemic diseases commonly ass w/ scleritis

Answer 7

RA,SLE, Wegners granulomatosis,

infections (rarely)

Question 8

Sx of scleritis?

Answer 8

severe boring eye pain, worse on movement

may radiate to brow and jaw

gradual onset

Question 9

Signs of scleritis?

Answer 9

diffuse engorgement of scleral vessels – mixed orientation of vessels
globe tender
no discharge
VA intially unaffected but may decrease

Question 10

Mgmt of scleritis

Answer 10

Oral/topical NSAIDS/corticosteroids