episcleritis + scleritis

Question 1

what are the features of episcleritis?

Answer 1

1. red eye
2. classically NOT painful in comparison to scleritis - mild pain or discomfort
3. watering and mild photophobia
4. visual acuity preserved

Question 2

what are the differences in injected vessels in episcleritis vs scleritis

Answer 2

injected vessels in episcleritis are mobile when gentle pressure is applied on the sclera

in scleritis vessels are deeper so do not move

Question 3

what can be used to differentiate scleritis and episcleritis

Answer 3

phenylephrine drops

Phenylephrine blanches the conjunctival and episcleral vessels but not the scleral vessels. If the eye redness improves after phenylephrine a diagnosis of episcleritis can be made

Question 4

what are the causes of episcleritis

Answer 4

wegner's
rheumatoid arthritis
SLE
vasculitis 
PMR

Question 5

how is episcleritis managed?

Answer 5

1. conservative
2. NSAIDs (ibuprofen)
3. artificial tears may be used

Question 6

what percentage of episcleritis is bilateral

Answer 6

50%

Question 7

what are the features of scleritis?

Answer 7

1. red eye
2. classically painful compared to episcleritis - worse on eye movement
3. watering and photophobia
4. gradual decrease in vision

Question 8

what are the features of scleritis?

Answer 8

1. red eye
2. classically painful compared to episcleritis
3. watering and photophobia
4. gradual decrease in vision

Question 9

what are the complications of scleritis

Answer 9

scleromalacia - thinning leading to globe perforation