Episcleritis

Question 1

What is epsicleritis?

Answer 1

= inflammation of the episclera (orginiates from superficial episcleral plexus: involves tenon’s capsule)

Question 2

What are the presentation/symptoms of episcleritis?

Answer 2

• Young adults, women > male
• Acute onset
• Unilateral redness
• Mild discomfort/irritation/grittiness
• Frequently recurrent

Question 3

What are two types of episcleritis? and their signs?

Answer 3

1. Simple Episcleritis (80%) - most common, sectoral or diffuse hyperaemia, resolves 7-10days
2. Nodular Episcleritis (20%) - more aggressive, localised, raised congested nodule, longer time course

Question 4

What is the management/treatment for episcleritis?

Answer 4

• No treatment required as its benign
• Ocular lubricants to relieve discomfort
• If persistant/recurrent
• > topical NSAIDs (Ketorolac)
• > Low dose topical corticosteroids (maxidex)
• > Systemic NSAID (Ibuprofen)

Question 5

What is the differential diagnosis for episcleritis?

Answer 5

• Conjunctivitis
• Scleritis
• Anterior Uveitis

Question 6

Episcleritis Vs Scleritis?

Answer 6

• If severe, deep, boring pain, progressively worsens = Scleritis (60+)
• Mild pain/discomfort = Episcleritis (vessels move with pressure and blanch with phenylphyine)
• Scleritis = EMERGENCCY REF
• Episcleritis = SELF LIMITING