Episcleritis

Question 1

Episclera - Anatomy (5)

Answer 1

connects sclera to conjunctiva

Lies under Tenons capsule

Loose connective tissue

Highly Vascular - Larger + darker than conjunctiva
Follow a radial pattern

Question 2

What are the risk factors ?

3

Answer 2

systemic condtions

1) collagen vascular disease
- Rheumatiod arthritis
- systemic lupus
- IBD

Question 3

Symptoms of Episcleritis

Answer 3

1) Red eye (unilateral)
2) Acute onset (12 hrs)
3) Mild / moderate discomfort ( no pain)
4) VA- normal
5) Photophobia
6) Epiphora

Question 4

Signs of Episcleritis

Answer 4

1) Red eye

Simple- sectoral / diffuse
Nodular - ( tender nodules move on palpation) last longer than simple
recurrent vessels - become dilated

2) 10 % phenylephrine = blanch episcleral vessels
3) Anterior chamber Quite
4) No vision / pain
5) No corneal + palpebral conjunctival involvement

Question 5

Management

Answer 5

1) Self- limiting
simple- 1-2 weeks to resolve
nodular 5-6 weeks

2) Cold compresses/ artifical tears
3) If no changes + worse tp return

Question 6

Recurrent refer over to Ophthalmology

Answer 6

Referral

1) Topical corticosteriods ( refer to opthalmology ) fluorometholone 1-2 weeks
2) sever cases topical NSAIDs flurbiprofen 100mg tds or naproxen 500mg bd