Episcleritis – Etiopathogenesis, Clinical features, Treatment

  • It is benign inflammation of the episclera and overlying tenon’s capsule
  • It is usually seen in young adults

Etiology:

  • Exact cause unknown
  • May be due to hypersensitivity to endogenous allergen – tubercular protein or streptococcal exotoxins
  • Associated with gout, rosaea and psoriasis

Pathology:

  • Lymphocytic infiltration of the episclera with edema and congestion of overlying tenon’s capsule

Clinical features

  • redness
  • grittiness
  • foreign body sensation
  • burning sensation

Types

  • Nodular episcleritis
    • Flat, firm, tender nodule seen 2-3 mm away from limbus
    • Surrounded by area of congestion
  • Diffuse episcleritis
    • The whole of the episclera is congested
    • More severe in 1 or 2 quadrants

Differential diagnosis

  • Inflamed pingecula
  • Foreign body reaction
  • Scleritis

Treatment

  • Topical steroids
  • NSAID’s
  • Cold compresses

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