- 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.
- 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
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 per 100,000 person-years)
Not historically well-known; a recent community study found a prevalence of 53 cases per 100,000 persons.
Etiology and Pathophysiology
- Etiology: usually idiopathic, but up to one-third of the patients can have systemic autoimmune conditions (1)
- 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: In rare cases, episcleritis can be the initial symptom of a systemic condition.
- Rheumatoid arthritis
- Inflammatory bowel disease
- Ankylosing spondylitis
- Psoriatic arthritis
- Systemic lupus erythematosus
- Herpes zoster
- Hypersensitivity disorders
- Contact dermatitis
- Penicillin sensitivity
- Erythema multiforme
- It can be an uncommon manifestation of other ocular infectious conditions.
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