Episcleritis and Scleritis
Episcleritis is an acute,relatively mild and non-vision threatening inflammation involving the episclera.Scleritis(in contrast to episcleritis) is usually a chronic and frequently severe vision-threatening inflammation of the sclera often associated with systemic disease.
Scleritis is divided into anterior scleritis and posterior scleritis.
History and Examination:
History:
Episcleritis:
----mild discomfort
----vision unaffected
Scleritis:
---usually severe boring /aching pain.Often disturbs sleep.
----tender eyeglobe
----nausea
----vision may be affeced(especially posterior scleritis)
EXAMINATION:
Episcletritis:
--vasodilataion of superficial episcleral plexus of blood vessels.
--the eyeglobe is not tender.
--no itra-ocular inflammtion.
Scleritis:
--vasodilataion of deep and superficial episleral plexuses of blood vessels.
--tendetr eyeglobe.
--corneal changes.
--intra-ocular inflammation(in advanced cases)
TREATMENT:
Episcleritis:for mild to moderate cases
no treatment is required.
If treatment is required ------give topical corticosteroids or systemic NSAIDs.
Scleritis: requires systemic treatment
with either NSAIDs(e.g. indomethacin) ,corticosteroids or other immunosuppressive drugs(including azathioprine,methotexate,cyclophophamide,cyclo-sporine A)