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Episcleritis

Definition

Episcleritis is irritation and inflammation of the episclera, a thin layer of tissue covering the white part (sclera) of the eye. It is not an infection.

Causes

Episcleritis is a common condition. In most cases the problem is mild and vision is normal.

The cause is often unknown. But, it may occur with certain diseases, such as:

• Herpes zoster virus
• Rheumatoid arthritis
• Sjögren syndrome
• Syphilis
• Tuberculosis

Symptoms

Symptoms include:

• A pink or purple color to the normally white part of the eye
• Eye pain
• Eye tenderness
• Sensitivity to light
• Tearing of the eye

Exams and Tests

Your health care provider or eye doctor will do an eye exam to diagnose the disorder. Most of the time, no special tests are needed.

Treatment

The condition most often goes away on its own in 1 to 2 weeks. Using corticosteroid eye drops may help ease the symptoms faster.

Outlook (Prognosis)

Episcleritis most often improves without treatment. However, treatment may make symptoms go away sooner.

Possible Complications

In some cases, the condition may return. Rarely, irritation and inflammation of the white part of the eye may develop. This is called scleritis.

When to Contact a Medical Professional

Contact your provider if you have symptoms of episcleritis that last for more than 2 weeks. Get checked again if your pain gets worse or you have problems with your vision.

References

Barry RJ, Denniston AK, Rhodes B, et al. Rheumatic disease. In: Sadda SVR, Sarraf D, Freund KB, et al, eds. Ryan's Retina. 7th ed. Philadelphia, PA: Elsevier; 2023:chap 81.

Cioffi GA, Liebmann JM. Diseases of the visual system. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 391.

Patel SS, Zaguia F, Goldstein DA. Episcleritis and scleritis. In: Yanoff M, Duker JS, eds. Ophthalmology. 6th ed. Philadelphia, PA: Elsevier; 2023:chap 4.11.

Promelle V, Goeb V, Gueudry J. Rheumatoid arthritis associated episcleritis and scleritis: an update on treatment perspectives. J Clin Med. 2021;10(10):2118. PMID: 34068884 pubmed.ncbi.nlm.nih.gov/34068884/.

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