Etiology, Clinical Features, and Management of Episcleritis

Introduction

Episcleritis is a common, benign inflammatory condition affecting the episclera of the eye. It often presents as a localized or diffuse redness and may be associated with mild discomfort.

Etiology

The exact cause of episcleritis is often idiopathic, but it can be linked to systemic conditions such as:

• Rheumatoid arthritis
• Systemic lupus erythematosus
• Inflammatory bowel disease
• Herpes simplex virus

Clinical Features

Patients typically present with:

• Sectoral or diffuse episcleral redness
• Mild discomfort or irritation
• Absence of photophobia and visual impairment
• Self-limiting nature

Diagnostic Approach: Examination and Investigations

Clinical Examination

The diagnosis of episcleritis is primarily clinical, based on characteristic signs and symptoms.

Investigations

While episcleritis is generally idiopathic, tests may be performed to identify underlying causes:

• Complete blood count (CBC)
• Erythrocyte sedimentation rate (ESR)
• Rheumatoid factor (RF)
• Antinuclear antibody (ANA)

Management

Most cases of episcleritis resolve spontaneously without treatment. However, supportive therapies include:

• Lubricating eye drops
• Cold compresses
• Topical or oral NSAIDs for symptomatic relief
• Management of underlying systemic conditions

Conclusion

Episcleritis is a benign and self-limiting condition that requires minimal intervention. However, persistent or recurrent cases should prompt further investigation to rule out underlying systemic diseases.