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Episcleritis: causes, symptoms, diagnosis, treatment
Last reviewed: 18.10.2021
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Epicleritis is an inflammation of the connective tissue that forms the outer surface of the sclera. Usually it is bilateral, as a rule, benign, occurs approximately in 2 times more often in women after 40 years. Epicleritis is clinically classified into simple diffuse and nodular types. Simple diffuse episcleritis occurs in 80% of cases, nodular - in 20%.
[Causes of episcleritis
The causes of episcleritis are very diverse. Earlier, the most common causes of episcleritis were tuberculosis, sarcoidosis, syphilis. Currently, a leading role in the development of episcleritis is streptococcal infection, pneumococcal pneumonia, inflammation of the paranasal sinuses, any inflammatory focus, metabolic diseases - gout, collagenosis. Some authors point out the connection between the appearance of sclerites due to rheumatism and polyarthritis. Pathological processes in sclerites develop as a bacterial allergy, sometimes they are of an autoimmune nature, which causes their persistent recurrent course. Injuries (chemical, mechanical) can also be a cause of scleral diseases. With endophthalmitis, panophthalmitis may be a secondary lesion of the sclera.
Symptoms of episcleritis
Episcelitis often develops on sites between the eyelids, there are sudden, causing lacrimation, pain, photophobia and redness. With diffuse episcleritis, the edge of hyperemia is poorly delineated and gradually disappears from normal tissue. The affected sclera has a color from pale to bright red. Hyperemia soon takes a lilac or purple hue. Episperler swells, so this zone seems somewhat sublime. Touching it causes minor pain, there are also independent, but not very severe pain. The epicler vessels are considerably expanded, but their radial course is not changed.
Symptoms of nodular episcleritis are similar to those of diffuse, but inflammatory processes are accompanied by the formation of nodules 2-3 mm in diameter, hard or soft to the touch. Conjunctiva above it is mobile. Sometimes there are several nodules that merge with each other. Episleritis lasts an average of 2-3 weeks, but can last from 5 days to many months. Nodular episcleritis usually lasts longer than its simple variety. The course of episcleritis is recurrent. Relapses and remissions of episcleritis alternate for several years, the damage sites often bypass the entire circumference of the eye. The decay and ulceration of episcleral infiltrates, which consist of lymphocytes with an admixture of epithelioid and giant cells, is never observed. Often amazed both eyes.
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Treatment of episcleritis
The outcome of episcleritis is almost always favorable; Episcleritis passes without a trace without treatment.
In case of recurrent course and pain, corticosteroids are applied topically (eye drops of decans, maxides, oftan-dexamethasone, hydrocortisone-PIC eye ointment) or non-steroidal anti-inflammatory drugs in the form of drops (tilt) 3-4 times a day. With persistent flow appoint non-steroidal anti-inflammatory drugs inside