Episcleritis is a common illness which causes inflammation of the eye. It is however not a malignant disease and it affects only a particular part of the eye known as episclera. Episcleral tissues lie between conjunctiva and the sclera. Conjunctiva is the mucous membrane coating the inner eyelid whereas sclera is the white portion of the eye.
There is no clear cause for episcleritis; however it can be linked with other illnesses such as Sjogren syndrome, syphilis, rheumatoid arthritis or inflammatory conditions like colitis, lupus etc. Some common symptoms are redness of eye, watery eyes, pain, change of color in the white portion of the eye (it may turn pinkish or purplish), sensitivity to light, and mild soreness; there are no problems in vision.
In few cases, a person might again suffer from episcleritis. In rare cases, the white part of the eye may develop irritation and swelling. This is known as scleritis.
Episcleritis is not a serious condition and hence does not need special treatment. It gets cured easily; still, oral or topical anti-inflammatory agents may be recommended to reduce pain in severe or frequent cases of episcleritis.
Types of Episcleritis
There are two main types of episcleritis, as mentioned below:
- Diffuse episcleritis, where the episclera is dispersedly/diffusely affected and the whole episclera becomes red.
- Nodular episcleritis, where the nodules present in the episclera are affected. These are more painful in comparison to diffuse episclera.
Some common signs and symptoms of episcleritis are as follows:
- Pain in eyes
- Redness of eyes
- Watering of eyes
- Eyes becomes tender
- Eyes become sensitive to light
- White portion of the eye may become purplish or pinkish
Causes of Episcleritis
- The exact reason as to why a person suffers from episcleritis is not known by the medical world.
- Only in about 1/3rd of the cases a certain cause for episcleritis is identified. Many diseases are linked with episcleritis; these include connective tissue illnesses; atopy; rosacea; systemic vasculitic illnesses such as nodosa, polyarteritis; ulcerative colitis; and gout. In rare cases, episcleritis can be due to scleritis.
- Statistics show that women are more prone to episcleritis in comparison to men. It usually affects people who are in their thirties and forties. At times it can be a recurrent problem.
- Episcleritis is also linked with other illnesses like tuberculosis, Sjogren syndrome, and syphilis as well as with inflammatory conditions like lupus and Irritable Bowel Syndrome or IBS.
- Some other uncommon underlying conditions that may cause episcleritis as a symptom include:
- Lyme disease
- Hay fever, Addison’s illness
- Herpes simplex infection
- Autoimmune diseases and disorders
- To diagnose episcleritis one has to visit clinic. In some cases, doctors may ask and test for detailed information about additional symptoms so as to identify a probable causal medical reason. Medical record of the affected person and various tests have to be conducted to know the physical health of the person.
- Special tests are usually not required in most cases. The doctor will examine the eye with the help of an instrument called slit lamp. It is a microscope with a light attached to it. Slit lamp has been specially designed for eye tests. Such tests are generally conducted by optometrist and few common practitioners.
- After completion of physical tests, history of the patient has to be checked for presence of illnesses linked with episcleritis, signs and symptoms like rashes, arthritis and viral infection.
- To differentiate episcleritis from scleritis the physician may use phenylephrine or neosynephrine eye drops. If blood vessels become blanched when these drops are used, then it means that it is episcleritis. If it turns blue, it is understood that it is scleritis and not episcleritis.
- After deadening the eye with medicines, the conjunctiva might be moved with a Q-tip to see the place of the inflamed blood vessel.
Treatment of Episcleritis
Episcleritis usually requires no medical treatment. Doctors may recommend oral or topical anti-inflammatory drugs to reduce associated pain, or if episcleritis is severe. Some other treatment options are listed below:
- Corticosteroid eye drops may be used to reduce the symptoms quickly
- Artificial tears can be opted for easing discomfort and irritation.
- Ketorolac: A topical NSAID drug known as Ketorolac may be taken; however, it is not very effective in comparison to artificial tears. Also it has more side effects.
On the whole episcleritis may disappear on its own within one or two weeks. However, medical treatment can help ease the symptoms faster as well as get rid of episcleritis quicker.
One should call the medical expert if the signs and symptoms of episcleritis continue for more than two weeks. If the condition worsens visit the medical expert again and check for visionary problems, if any exist.
Episcleritis – Pictures