Hello and welcome to the Zero to Finals podcast. My name is Tom and in this episode I'm going to be talking to you about

episcloritis. And if you want to follow along with written notes on this topic, you can follow along at

0.0.3.com slash episcloritis or in the ophthalmology section of the zero de finals medicine book so let's get

straight into it episcleritis is a benign and self-limiting condition that causes inflammation of the

episclera which is the outermost layer of the sclera the episclera is situated just underneath the conjunctiva.

Episcleritis is relatively common in young and middle-aged adults, and it's not usually caused by

an infection. It's often associated with inflammatory disorders like rheumatoid arthritis or

inflammatory bowel disease. How does it present? Well, episcleritis usually

presents with acute onset unilateral symptoms. Typically it's not painful but there can be mild

discomfort or mild pain. There'll be segmental redness. So redness in a very small area rather than diffuse redness throughout the eye. This is usually a patch of redness, so redness in a very small area rather than diffuse redness throughout the eye.

This is usually a patch of redness in the lateral sclera, so slightly lateral to the iris.

There'll be a feeling of a foreign body sensation like something stuck in the eye.

There can be dilated episcleral vessels, some watering of the eye, but there won't be any discharge from the eye, there can be dilated episcleral vessels, some watering of the eye, but there

won't be any discharge from the eye, unlike conjunctivitis.

So how do we manage episcleritis?

Well if there's doubt about the diagnosis, refer the patient to ophthalmology for an assessment.

Episcleritis is usually a self-limiting condition and patients will make a full

recovery within one to four weeks. In mild cases, no treatment is necessary, but lubricating

eye drops can be helpful to alleviate the symptoms or the feeling of a foreign body sensation.

Management is with simple analgesia, cold compresses against the eye,

and safety net advice that if things are getting worse or they develop pain

or change in vision, they need to seek further medical attention.

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