Episcleritis is a benign inflammation of the tissues beneath the conjunctiva and above the sclera. It commonly affects both eyes and is more frequent in young adults and females. Episcleritis can be idiopathic or associated with systemic diseases. Clinically, episcleritis presents as redness of the eye with mild pain or discomfort. Treatment involves lubricants and topical or oral anti-inflammatory drugs.

1. Jenan Muhammed
ESIC &PGIMSR

2.  Definition
 Epidemiology
 Etiology
 Pathology
 Types
 Clinical picture
 Differential diagnosis
 Management

3.  Episcleritis is a benign inflammation of deep
subconjuctival connective tissue in including
superficial scleral lamellae.
 Frequently affects both eyes

4.  Age- seen in young adults
 Sex- twice common in females

5.  Idiopathic
 Systemic disease- asso with Gout, Rosacea,
Psoriasis,CT tissue disordes – RA
 Hypersensitivity Rn- Endogenous tubercular or
staphylococcal toxin
 Infectious Episcleritis- HZV, Syphilis, Lyme
disease, tuberculosis

6.  Histologically – dense lymphocytic infiltration
with non granulomatous inflammation
 Characterized by vascular dilatation
Episcleral n Subconjunctival tissues

7. Normal sclera
Episcleritis Scleritis

8.  Simple-
 Sectoral or Diffuse redness of one or both eyes
due to engorgement of large episcleral vessels
in radial direction.
Mild to mod tenderness over area of episcleral
injection

9.  Nodular-
 Circumscribed pink or purple nodule of dense
leucocytic infiltration ,2-3 mm from limbus
Hard, tender immovable (at most can be
moved slightly over underlying sclera, with
conjunctiva moving freely over it)

10.  Redness
 Little or no pain
 Ocular discomfort- gritty, foreign body,
burning
 Mild photophobia
 Lacrimation
 Sometimes severe neuralgia

11.  Mild- lubricants, topical NSAIDs
 Moderate to severe-
 Mild topical steroids- fluorometholone QID
 If unsuccessful – oral NSAIDs (ibuprofen 400
mg oral 3 or 4 times a day, Indomethacin 25
mg TID, aspirin)