Episcleritis is an eye disease characterized by an inflammatory process on the outer layer of the sclera. Most often occurs at a young age. It can often recur, while never spreading into the deep layer of the sclera.
Reasons
There is no unambiguous answer to the question of what is the cause of the development of episcleritis. Often, the disease is provoked by the development of diseases such as polyarteritis nodosa, Wegener’s granulomatosis, recurrent polychondritis, the spread of bacterial flora from the cornea or conjunctiva of the eye. Sometimes the disease develops as a reaction to certain chemicals, as well as infections of bacterial, fungal nature, viruses (including herpes), the presence of parasitic infections, tuberculosis.
Kinds
It is customary to divide the disease into types depending on the form of the course. Diffuse episcleritis is called with a wide spread of the inflammatory process over the area of the sclera. The nodular form of the disease is expressed by a limited nodule with reddened inflamed vessels.
The diffuse or simple form is more common. With it, pain is more pronounced and this form of the disease lasts longer than nodular.
Symptoms
Patients complain of the development of pain syndrome, which becomes more intense with the growth of the inflammatory process. However, the pain is not as intense as with inflammation of all layers of the sclera. The inflammatory process provokes redness of the sclera, which can be widespread or limited. The pain syndrome and redness are joined by lacrimation, provoked by irritation of the nerve endings. Sometimes patients complain of photophobia. The separated tear is transparent, without impurities.
The disease is characterized by a recurrent course, which can last 7-14 days with an interval of 30-90 days. As a rule, the intensity of the course of the disease depends on the presence of concomitant diseases in the patient.
Diagnostics
The diagnosis of this eye ailment is carried out taking into account the possible causes that provoked its development. Complaints are also carefully collected and the clinical picture is analyzed. The main task of the diagnostic program is to determine the severity of the inflammatory process. The doctor should determine whether to talk about episcleritis (a process in which only the outer shell of the sclera becomes inflamed) or about scleritis (a process in which all layers of the sclera become inflamed). Both the prognosis of the disease and the treatment tactics depend on the accuracy of determining the extent of the spread of the process.
A diagnostic measure is the instillation of vasoconstrictive drops into the eye, followed by monitoring the reaction of the vessels. With scleritis, the vessels dilated as a result of inflammation do not react to the action of drops and remain unchanged. With episcleritis, redness disappears for a while due to narrowing of the lumen of irritated vessels.
For the diagnosis of episcleritis, tests for uric acid, rheumatoid factor, ESR level in the general blood test, fluorography, syphilis test, antinuclear antibodies can be useful.
Treatment
In most cases, episcleritis passes without a trace. Often this process proceeds independently or in the course of the therapy undertaken in 7-14 days. Unpleasant symptoms with this ailment are removed with the use of natural tear preparations or anti-inflammatory drops. Sometimes the use of drops with glucocorticoids is indicated. But due to the high risks of provocation of the development of glaucoma and cataracts under their influence, such drugs should be used with caution.
Relapses of this disease are removed with the use of NSAIDs taken in the form of tablets in short courses.
