Episcleritis
BASICS
- Episcleritis is irritation and inflammation of the episclera, a thin layer of vascular connective tissue between the conjunctiva and sclera.
- Usually a benign self-limited condition, typically resolving without treatment within 3 weeks
- Topical lubricants and/or topical corticosteroid treatment may relieve symptoms while awaiting spontaneous resolution.
DESCRIPTION
- Edema and injection confined to the episcleral tissue
- Two types
- Simple episcleritis: diffuse scleral involvement—more common
- Nodular episcleritis: focal area(s) of involvement—less common
EPIDEMIOLOGY
Slight female predominance (~60–65%)
Incidence
- May occur at any age
- Peak incidence in 40s to 50s
- Community incidence not well-known (~20 to 50 cases per 100,000 person-years)
Prevalence
Not historically well-known; a recent community study found a prevalence of 53 cases per 100,000 person-years.
ETIOLOGY AND PATHOPHYSIOLOGY
- Etiology: usually idiopathic, but up to 1/3 of the patients can have systemic autoimmune conditions (1)
- Pathophysiology:
- Nonimmune (e.g., dry eye syndrome, with histology showing widespread vasodilation, edema, lymphocytic infiltration)
- Immune (systemic vasculitis or rheumatologic disease)
COMMONLY ASSOCIATED CONDITIONS
- Usually not associated with another condition
- One-third of the cases have a systemic autoimmune disease (2):
- Rheumatoid arthritis
- Vasculitis
- Inflammatory bowel disease
- Ankylosing spondylitis
- Psoriatic arthritis
- Systemic lupus erythematosus
- Gout
- Herpes zoster
- Hypersensitivity disorders
- Rosacea
- Contact dermatitis
- Penicillin sensitivity
- Erythema multiforme
- It can be an uncommon manifestation of other ocular infectious conditions
There's more to see -- the rest of this topic is available only to subscribers.
© 2000–2025 Unbound Medicine, Inc. All rights reserved
All content is protected by copyright and may not be used for AI model training or other unauthorized purposes.