Episcleritis

Episcleritis
SYMPTOMS Discomfort/irritation | Often asymptomatic
SIGNS Sectoral or diffuse injection | Sometimes a nodule is present.
WORK-UP Thorough history. Slit lamp examination
TREATMENT
Observation | Preservative-free artificial tears | If significant, topical steroids may be used: Lotemax 1 gtt OU qid x 1 week | Pred Forte 1% 1 gtt OU qid x 1 week
Oral NSAIDs may be prescribed - ibuprofen 800 mg po tid
FOLLOW-UP Every 1-2 weeks during treatment
ADDITIONAL LAB | TESTS Blood work can be ordered with chronic recurrence or if suspicion of systemic disease is present
ETIOLOGY Usually idiopathic, but could be caused by inflammation or infectious processes
DIFFERENTIAL DX Scleritis | Phlyctenular conjunctivitis
NOTES Differentiate episcleritis from scleritis with the blanch test using 2.5% phenylephrine

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