Episcleritis

  • Inflammation of deep subconjunctival (episcleral) tissue
  • May be isolated to eye or component of viral or idiopathic autoimmune condition
  • Usually self-limited but may be recurrent
  • Viral conjunctivitis, inflamed pinguecula, scleritis, BUT...
  • Viral conjunctivitis rarely displays focal engorgement of conjunctival vessels and causes more discharge and often enlargement and tenderness of ipsilateral preauricular node
  • Inflamed pinguecula always located adjacent to corneal limbus on nasal (less often temporal) side
  • Scleritis causes much more eye pain and focal tenderness
  • Refer urgently to ophthalmologist if diagnosis in question
  • Otherwise treat with oral nonsteroidal anti-inflammatory agent (NSAID); if no response within 2 days, refer to ophthalmologist
  • Manifestations usually resolve spontaneously or within days of oral NSAID treatment; if not, question diagnosis and refer to ophthalmologist