Episcleritis/Scleritis Flashcards
What is shown?
Nodular Episcleritis
What is this?
Diffuse Scleritis
What is this an example of?
Scleral Thinning
What is this?
Nodular Scleritis
How do the vessels run in the episclera?
Straight vessels in a radial configuration
What is this?
Scleromalacia Perforans
What is slcera made of?
Highly organized collagen, elastin, glycoproteins and proteoglycans
What innervates the sclera?
Short and long ciliary nerves
What vessels blanch easily with phenylephrine?
Superficial episcleral plexus vessels
Which plexus is most affected in slcleritis?
Deeper episcleral plexus
What are the two types of episcleritis?
Simple - most common
Nodular
What are the types of slceritis anterior?
Non-necrotizing (95%)
- Diffuse (90%)
- Nodular (5%)
Necrotizing (5%)
- w/inflammation
- w/o inflammation (scleromalacia perforans
2/3 of episcleritis is ___.
Idiopathic
When in episcleritis most common?
Spring and fall - don’t confuse with allergic conjunctivitis
What is the general presentation of episcleritis?
Mild, transient, recurrent, idiopathic inflammation
Often bilateral and sectoral
Symptomes may be none to moderate (some pain from nodular)
Typically sectoral, but may be diffuse
Episcleritis is ___ and generally lasts ___.
Self-limiting
2-21 days
Nodular variety takes longer
What are the common treatments for episcleritis?
Often none
In nodular you may use:
Artificial tears
Topical steroid
Topical NSAID
If phenylephrine causes the hyperemia to dissipate, what is the probable disease?
Episcleritis
What are the signs/symptoms of diffuse episcleritis?
Redness followed by aching and pain
-Boring pain may radiate to brow, forehead, ear, jaw and temple
Nocturnal pain wakes patient; improves during day
Redness commonly starts in superior temporal quadrant
Intense red/purple hue with deep plexus injection
*Tender to palpation
Lacrimation, photophobia
*Bliateral 50%
At what age does diffuse scleritis usually occur?
45-60 , but very rare overall
50% have underlying disease
What is seen with scleral thinning?
Underlying dark uveal pigment becomes visible
Recurrence of ___ scleritis is common.
Nodular
20% of nodular scleritis may progress to ___.
Necrotizing
Many patients with nodular scleritis have previously had what?
HZV of the eye
