Nontraumatic Red Eye 39
Episcleritis Description Episcleritis is characterized by a salmon-pink hue of the superficial layer of the eye, with involvement of the conjunctiva and episclera (Plate 19). At least one-third of the lesions are tender to touch. Simple episcleritis may be sectoral in 70% or generalized in 30% of patients. In nodular episcleritis, unlike in nodular scleritis, the nodules which form are moveable with a cotton swab. Most cases of episcleritis are idiopathic; however, up to one third of cases may have an underlying systemic condition.
Plate 19 Episcleritis with sectorial injection of the conjunctiva and episcleral tissue
Workup. Ophthalmic referral is recommended. Treatment. A topical steroid (e.g., Flarex速 q.i.d.) will cause resolution of the inflammation.
Scleritis Description Scleritis is frequently bilateral and, characteristically, associated with severe pain. The disease may involve the anterior (visible segment) and/or posterior segment (less frequent). The ocular surface has a purplish hue with involvement of the deep episcleral vessels (Plate 20). Systemic diseases, such as collagen vascular, ulcerative
Plate 20 Scleritis with diffuse involvement of the deep episcleral vessels