Episcleritis and scleritis Flashcards
What is episcleritis?
Inflammation of the episclera = vascular + connective tissue membrane between the conjunctiva and sclera
How does episcleritis present?
Symptoms:
Few, mild irritation, NOT PAINFUL (if so = red flag for scleritis)
Signs:
Intense very localised redness (but can be diffuse), possibly mistaken for haemorrhage
Common, usually affecting one eye only
How do you manage episcleritis?
Is common, idiopathic and benign so just needs reassurance
How does scleritis differ in presentation and management?
Scleritis is painful - not discomfort but actual pain, sometimes that wakes people us/stop people sleeping
People are often older with a Hx of a chronic inflammatory disease
Needs URGENT REFERRAL as can lead to eye loss/permanent damage if unchecked
What is a subconjunctival haemorrhage?
When one or more blood spots appear on the white of your eye.
The conjunctiva contains a lot of tiny blood vessels that can break - blood leaks between the conjunctiva and sclera
Aetiology:
- Coughing, sneezing, straining, or other similar actions most commonly cause because they briefly raise blood pressure in your capillaries -> break.
- Trauma to the eye; even rubbing your eyes too hard
Less common causes:
- Diabetes
- High blood pressure
- Anticoagulants
- Clotting disorders
How do you manage subconjunctival haemorrhage?
These blood spots can look scary but a subconjunctival hemorrhage is usually harmless and often heals on its own in about 2-3wks
Check BP, check blood sugar, check INR/clotting
