Scleritis and episcleritis

Question 1

symptoms of scleritis

Answer 1

• red sclera
• severe ocular pain (10/10), may radiate to jaw/temple
• photophobia
• tearing
• decrease in visual acuity, possibly leading to blindness.

Question 2

symptoms of episcleritis

Answer 2

painless/mild pain

red eye

Question 3

scleritis/episcleritis associated with what

Answer 3

episcleritis = UC, crohn’s (sometimes RA, SLE, wegener’s)

scleritis:
RA (by far the most)
SLE
wegener’s, anky spond

NB scleritis is much more likely to be associated with another condition. episcleritis on it’s own

Question 4

ix to differentiate between scleritis and episcleritis

Answer 4

phenylephrine only works on outer layer of sclera - causing vasoconstriction of outer vessels - will mask episcleritis but not scleritis

episcleritis - light pressure applied to the eye with a cotton bud - vessels seem to move in episcleritis (since they are more superficial)

Question 5

treatment of episcleritis

Answer 5

self limiting (1-2 weeks)
may want lubricating eye drops and if severe (rare) topical steroids/NSAIDs)

Question 6

scleritis rx

Answer 6

treat underlying disease

NSAIDs. oral pred if not effective

Question 7

complications scleritis

Answer 7

raised IOP
retinal detachment
uveitis
cataract
scleral thinning