Episcleritis DOES NOT progress to scleritis

Episcleritis is inflammation of the superficial, episcleral layer of the eye. It is relatively common, benign and self-limiting.

Aetiology:

• Most cases of episcleritis have no identifiable cause, although a small number are associated with systemic inflammatory conditions.

Epidemiology:

• More frequent in younger patients

2 types of episcleritis:

• Simple episcleritis: characterised by vascular congestion on an even episcleral surface. This can affect a single segment of the episclera or all of it (diffuse episcleritis).
• Nodular episcleritis: characterised by a discrete elevated area of inflamed episclera.

PC

[Important to rule out scleritis when diagnosing episcleritis]

• Acute onset of red eye
• Typically not painful, there may be mild pain
• No discharge other then watering

On examination:

• Sectorial redness in one or both eyes
• Normal visual acuity and pupillary reactions
• Episcleral vessels can be moved with a cotton bud. When phenylephrine 10% is applied, they blanch (this will also dilate the pupil).