Episcleritis: Red Eye (Diagnose & Treat) Flashcards
What is episcleritis?
Inflammation of the episclera
What is the episclera?
Thin, vascular/connective tissue between the conjunctiva and the sclera
What is the prognosis?
Common, idiopathic and benign
What must you differentiate it from?
Scleritis (white, tough outer coating - uncommon/serious/autoimmune)
Scleritis is classically painful and episcleritis is not or mildly painful
What are the signs?
How do they differ from Scleritis?
Episcleritis:
Unilateral (50%) red eye (looks like burst vessels, follows vessels), mild or no irritation (not painful)
Intense/localised redness, mistaken for haemorrhage but can be diffuse.
Watering and mild photophobia may be present
Scleritis:
Darker redness, often nodular, usually severely painful.
How do the injected vessels differ in episcleritis and scleritis?
In episcleritis, the injected vessels are mobile when gentle pressure is applied on the sclera.
In scleritis, the vessels are deeper, hence do not move
What drug may be used to differentiate between episcleritis and scleritis?
Phenylephrine drops
Phenylephrine drops blanch the conjunctival and episcleral vessels but not the scleral vessels.
If the eye redness improves a diagnosis of episcleritis can be made.
What is the prognosis?
Resolves in 1-2 weeks, reassure
What is the management of episcleritis?
Conservative
Artificial tears
