Ver el código de «Episcleritis»

==Background==
*Abrupt onset of inflammation in the episclera
*70% of cases occurs in women (usually young/middle-aged)
*Usually a benign, self-limited condition
*Can be classified into simple (more common) or nodular types
*Most commonly idiopathic but may occur as an ocular manifestation of underlying autoimmune conditions eg [[RA]], [[IBD]]
*Also associated with [[glaucoma]] and cataracts<ref>Honik G, Wong IG, Gritz DC; Incidence and prevalence of episcleritis and scleritis in Northern California. Cornea. 2013 Dec;32(12):1562</ref>

==Clinical Features==
[[File:Episcleritiseye.jpg|thumb|Episcleritis]]
===History===
*Abrupt onset of [[red eye|redness]], irritation, and watering of the eye
*Pain is unusual
*Vision unaffected
*50% of cases are bilateral

===Physical exam===
*Vasodilatation of the superficial episcleral vessels
*Focal area(s) of redness 
*May have a tender scleral nodule (nodular episcleritis)

==Differential Diagnosis==
{{Unilateral red eye DDX}}

==Evaluation==
*Must distinguish from [[scleritis]]
**Scleritis likely to have pain and decreased vision 
**Use of 2.5% phenylephrine drops will cause vasoconstriction/blanching of episcleral but not scleral vessels. Thus, there will be decreased injection and redness in episcleritis but not scleritis.<ref>Mahmood AR, Narang AT. Diagnosis and management of the acute red eye. Emerg Med Clin North Am 2008; 26:35-55.</ref>
**Red area will be mobile if moved with a moist q-tip
*Must distinguish from [[conjunctivitis]]
**Episcleritis will usually have a sectoral pattern of injection, as opposed to a diffuse injection seen in conjunctivitis.

==Management==
*Topical lubricants
**Artificial tears q4-6hr
*Oral [[NSAIDs]]
*[[Topical steroids]] may relieve symptoms but are associated with rebound redness and potentially worse future events and are generally not recommended<ref>Akpek EK, Uy H, Christen W, et al. Severity of episcleritis and systemic disease association. Ophthalmology. 1999;106:729.</ref>

==Disposition==
*Refer to ophtho is unsure of diagnosis or if steroids are necessary for treatment
*Self-limiting (will resolve within 2-3 weeks)

==See Also==
*[[Scleritis]]

==External Links==

==References==
<references/>

[[Category:Ophthalmology]]