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- Episcleritis is irritation and inflammation of the episclera, a thin layer of tissue covering the sclera. It is not an infection.
- Episcleritis is the localized inflammation of the vascular connective tissue superficial to the sclera.
- Usually a self-limited condition, typically resolving within 3 weeks
- Most cases resolve without treatment.
- Topical lubricants and/or topical corticosteroid treatment may relieve symptoms while awaiting spontaneous resolution.
- Edema and injection confined to the episcleral tissue
- Two types
- Simple (diffuse scleral involvement—more common)
- Nodular (focal area[s] of involvement—less common)
Slight female predominance (~60–65%)
- May occur at any age
- Peak incidence in 40s to 50s
- Community incidence not well-known (~20 to 50 cases/100,000 person-years)
Not historically well-known; a recent community study found a prevalence of 53 cases/100,000 persons.
Etiology and Pathophysiology
- Etiology: usually idiopathic, but other causes may be found (either nonimmune or immune)
- 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
- Less commonly associated conditions include the following:
- Rheumatoid arthritis
- Inflammatory bowel disease
- Ankylosing spondylitis
- Systemic lupus erythematosus
- Herpes zoster
- Hypersensitivity disorders
- Contact dermatitis
- Penicillin sensitivity
- Erythema multiforme