Episcleritis
- Self-limited inflammation of the episcleral layers (loose connective tissue layers with a vascular plexus between the conjunctiva and the sclera that are contiguous with Tenon's capsule)
- Female Adults more common than Male adults and both more common than in children
- More common in boys than girls
- 50% may have a concurrent eye disease
Associated Conditions
- Collagen Vascular Diseases
- Rheumatoid Arthritis (most common)
- Chron's disease
- Ulcerative colitis
- Psoriatic arthritis
- Systemic lupus erythematosis
- Reactive arthritis (Reiter syndrome)
- Relapsing polychondritis
- Ankylosing spondylitis
- Pustulotic artho-osteitis
- Vasculitis
- Polyartitis Nodosa
- Temporal Arteritis
- Cogan Syndrome
- Churg-Strauss Syndrome
- Granulomatosis with polyangiitis
- Bechet Disease
- Dermatologic disease
- Rosacea
- Pyoderma gangrenosum
- Sweet syndrome
- Metabolic disease
- Gout
- Atopic disease
- Malignancies
- T-cell leukemia
- Hodgkin lymphoma
- Ocular
- Foreign bodies
- Chemical injury
- Infections
- Mycobacteria
- Spirochetes
- Treponema
- Borrelia
- Chlamydia
- Actinomyces
- Fungi
- Virus
- Herpes Zoster
- Herpes Simplex
- Mumps
- Chikungunya
- COVID-19
- Protozoa
- Acanthamoeba
- Toxoplasma
- Toxocara
- Medications
- Topiramate
- Pamidronate
Work-Up
- Consider if recurrent or other signs consistent with connective tissue disease (joint pain, fevers etc) vascular or dermatologic disease
- Possible testing:
- Rheumatoid factor (Rheumatoid Arthritis)
- Antinuclear antibody (collagen vascular disease)
- Serum uric acid (gout),
- Erythrocyte sedimentation rate (inflammation, vasculitis),
- Complete blood count with differential (infection, malignancy)
- VDRL/FTA-ABS (spirochete infection)
- Urinalysis
- PPD or Quantiferon Gold (mycobacteria)
- Chest x-ray (mycobacgteria)
- HLA-B27 (collagen vascular disease)