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Episcleritis
is recurring inflammation of the episcleral tissue of unknown etiology
that is self-limiting and does not threaten vision. Symptoms are
a localized area of hyperemia of the globe, irritation, and lacrimation.
Diagnosis is clinical. Treatment is symptomatic.
Episcleritis occurs in young adults, more commonly among women. It is usually idiopathic; it can be associated with connective tissue diseases but rarely with serious systemic diseases.
Mild irritation occurs. Additionally, a bright red patch is present just under the bulbar conjunctiva (simple episcleritis). A hyperemic, edematous, raised nodule may also be present (nodular episcleritis). The palpebral conjunctiva is normal.
Episcleritis is distinguished from conjunctivitis because hyperemia is localized to a limited area of the globe and lacrimation is much less. It is distinguished from scleritis by lack of photophobia and lack of severe pain.
The condition is self-limited, and a diagnostic assessment for systemic disorders is not routinely warranted. A topical corticosteroid (eg, prednisolone acetate, 1% drops qid for 5 days and gradually reduced over 3 wk) or an oral NSAID usually shortens the attack; corticosteroids are usually prescribed by an ophthalmologist. Topical vasoconstrictors (eg, tetrahydrozoline ) to improve the appearance are optional.
Last full review/revision June 2008 by Mitchell H. Friedlaender, MD
Content last modified June 2008
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