Episcleritis/scleritis Flashcards
What is the episclera?
This is situated underneath the conjunctiva and is the outermost layer of the sclera
What is episcleritis?
This is the benign and self limiting inflammation of the episclera
What is episcleritis associated with?
Inflammatory disorders such as: rheumatoid arthritis and IBD
What does episcleritis usually present with?
Typically it isn’t painful but there can be mild pain Segmental redness Foreign body sensation Dilated episcleral vessels Watering of eye No discharge
How do you manage epIscleritis?
Usually self limiting and will recover in 1-4 weeks
Lubricating eye drops can help symptoms
Simple analgesia, cold compresses and safety met advice are appropriate
More severe cases may benefit from systemic NSAIDS (naproxen) or topical steroid eye drops.
What is scleritis?
Inflammation of the full thickness of the sclera, it is more serious than episcleritis which is just the surface layer of the sclera.
What is necrotising scleritis?
This is the most severe type of scleritis
Most people with necrotising scleritis have visual impairment but may not have pain
What is the most significant complication of scleritis?
Perforation of the sclera.
What are the associated systemic conditions with episcleritis?
Rheumatoid arthritis Systemic lupus erythematous Inflammatory bowel disease Sarcoidosis Granulomatosis with polyangiitis
What is the presentation of scleritis?
Severe pain Pain with eye movement Photophobia Eye watering Reduced visual acuity Abnormal pupil reaction to light Tenderness to palpation of the eye
What is the management of scleritis?
Consider an underlying systemic condition
NSAIDS (topical/systemic)
Steroids (topical/systemic)
Immunosuppresion appropriate to the underlying condition ie: methotrexate in rheumatoid arthritis.
