What is episcleritis?

Episcleritis is an inflammation of the episclera, the tissue that lies just under the outer skin of the white of the eye. Commonest between the ages of 40 to 60, it usually affects just one eye but both eyes are affected in a quarter to a half of cases. In about one in three of cases there is a background of inflammation elsewhere in the body, for example rheumatoid arthritis or inflammation of the bowel.

The condition begins without warning and patients experience redness, aching and tenderness of one or both eyes. The vision is not affected. Episcleritis often disappears in a week to ten days. In some patients, it may return again later. The optometrist will reach a diagnosis based on the exact type of inflammation, which distinguishes this condition from conjunctivitis (inflammation of the outer skin of the eye) and scleritis (inflammation of the white part of the eyeball).

How is episcleritis managed?

Cold compresses may relieve the symptoms, as may artificial tears in eye drop form. If the inflammation is more severe, steroid eye drops may be prescribed, and sometimes anti-inflammatory tablets are needed also.

After the second recurrence, the optometrist may refer the patient for investigation by the ophthalmologist.