Episcleritis

What is episcleritis? Information about the causes, symptoms, types, and treatments of this condition.

Symptoms and Causes

Episcleritis is the inflammation of the episclera, a thin vascular membrane that is the outer layer of the sclera, the white, fibrous, and tough membrane that covers the eyeball. It is a relatively common condition, generally benign and of limited duration. It typically affects one eye, although both eyes may be affected in rare cases.

Depending on the affected area, two types of episcleritis are distinguished:

Diffuse or simple episcleritis: affects the entire episclera.
Nodular or nodose episcleritis: appears in a small, well-defined area. This type of episcleritis typically takes longer to resolve.

Symptoms

The common symptoms of episcleritis are usually mild and include:

Redness and swelling in the white part of the eye. Occasionally, a yellowish tint may appear.
Ocular sensitivity to touch and light.
Irritation or burning sensation.
Increased tearing.
In the case of nodular episcleritis, the formation of a nodule with redness around it, which may be movable.

Causes

In most cases, episcleritis is an idiopathic condition, meaning there is no specific factor that causes it. However, it is sometimes associated with various systemic diseases, most frequently the following:

Connective tissue diseases, such as lupus or rheumatoid arthritis.
Systemic vascular diseases, such as polyarteritis nodosa or Wegener's granulomatosis.
Ulcerative colitis.
Atopy.
Gout.
Rosacea.
Ocular herpes zoster.

Risk Factors

The factors that increase the risk of developing episcleritis include:

Age: it is more common in young adults.
Gender: more frequent in women.
Presence of the aforementioned systemic diseases.

Complications

Although episcleritis generally has a good prognosis and does not lead to complications, in a small percentage of cases, it may progress to scleritis, a serious granulomatous inflammation of the sclera that presents symptoms similar to episcleritis, but with more intense pain, and it can potentially compromise vision.

Additionally, when episcleritis is secondary to other diseases, recurrence is common.

Prevention

No methods have been described to prevent episcleritis. However, especially if one suffers from any of the systemic diseases commonly associated with episcleritis, it is advisable to undergo periodic ophthalmologic check-ups.

What doctor treats episcleritis?

Episcleritis is diagnosed and treated in the ophthalmology unit.

Diagnosis

After describing the symptoms and reviewing the patient's medical history, episcleritis is confirmed through an eye examination, with the primary goal of differentiating it from scleritis. Usually, observing the symptoms manifested by the patient is sufficient for diagnosis. However, in some cases, the topical application of adrenaline or phenylephrine to the affected area may be used. If it is episcleritis, the reddened area will blanch, which does not occur in scleritis.

Treatment

Episcleritis typically resolves on its own within one to two weeks. However, the following treatments can be applied to reduce inflammation, alleviate symptoms, and shorten the healing process: