Eye Health More Eye Issues & Safety Episcleritis Symptoms and Treatments By Troy Bedinghaus, OD Troy Bedinghaus, OD LinkedIn Troy L. Bedinghaus, OD, board-certified optometric physician, owns Lakewood Family Eye Care in Florida. He is an active member of the American Optometric Association. Learn about our editorial process Updated on April 23, 2022 Medically reviewed by Johnstone M. Kim, MD Medically reviewed by Johnstone M. Kim, MD Johnstone M. Kim, MD, is board-certified in ophthalmology. He's a practicing physician at Midwest Retina in Dublin, Ohio and previously served as a full-time faculty member at the Wayne State University School of Medicine and the Kresge Eye Institute in Detroit, Michigan. Learn about our Medical Expert Board Fact checked by Angela Underwood Fact checked by Angela Underwood LinkedIn Angela Underwood's extensive local, state, and federal healthcare and environmental news coverage includes 911 first-responder compensation policy to the Ciba-Geigy water contamination case in Toms River, NJ. Her additional health-related coverage includes death and dying, skin care, and autism spectrum disorder. Learn about our editorial process Print Table of Contents View All Table of Contents Symptoms Causes Treatment Treatment What You Should Know Episcleritis is an acute inflammatory disorder of the episclera, the thin tissue between the conjunctiva and the white sclera. The episclera houses a thin network of blood vessels. Episcleritis usually looks much worse than it actually is. Although most cases of episcleritis go away on their own if left alone long enough;however, some cases are linked to hidden inflammatory problems present somewhere else in the body. Creative RF / Getty Images Symptoms Episcleritis sometimes produces a section of redness in one or both eyes. Some people may develop a white nodule of tissue in the center of the redness, known as nodular episcleritis. Many people with episcleritis have some associated pain or discomfort, but others have none. Other symptoms that may occur with episcleritis are sensitivity to light (photophobia) and a watery discharge from the eyes. Causes In most cases of episcleritis, healthcare providers find it difficult to find out a clear cause. In more severe forms of episcleritis, underlying conditions such as inflammatory bowel disease, Crohn’s disease, and ulcerative colitis are usually the culprits. Other conditions that cause inflammation to the episcleritis include: Rheumatoid arthritis and psoriatic arthritis Polyarteritis nodosa Sarcoidosis Lupus Ankylosing spondylitis Types of Episcleritis There are two forms of episcleritis: simple and nodular.Simple episcleritis: The most common type, simple episcleritis causes bouts of recurring inflammation. Each bout usually lasts from 7 to 10 days, although longer episodes may occur when the condition is associated with another systemic condition.Nodular episcleritis: Nodular episcleritis produces more painful attacks of inflammation. Many people with nodular episcleritis have an associated systemic disease. Treatment Episcleritis may go away on its own within 3 weeks if left untreated. Most healthcare providers treat episcleritis to hasten recovery. Treatment of episcleritis usually involves the following: Topical corticosteroids eye drops given several times per day Topical lubricant eye drops such as artificial tears Cold compresses 3 to 4 times per day Non-steroidal anti-inflammatory medications given by mouth are prescribed in more severe cases What You Should Know In some cases of episcleritis, scleritis may develop, an inflammation of the sclera that can cause intense pain and loss of vision. Contact your healthcare provider if you have symptoms of episcleritis that last for more than 2 weeks or if you have a loss of vision. Episcleritis vs. Scleritis Episcleritis occurs in the thin tissue between the conjunctiva and the white sclera. The episclera houses a thin network of blood vessels. The sclera is the tough, white exterior coating of the eyeball. Although having episcleritis is definitely a cause for concern, scleritis is usually considered a more serious condition and often is more painful and tender to touch. Scleritis can even be a blinding disease and is typically associated more with autoimmune disorders such as rheumatoid arthritis. Optometrists and ophthalmologists are trained to differentiate between episcleritis and scleritis. Because scleritis is sometimes related to systemic autoimmune conditions, your condition will be co-managed with a primary care healthcare provider, rheumatologist or internal medicine practitioner. 11 Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Salama A, Elsheikh A, Alweis R. Is this a worrisome red eye? Episcleritis in the primary care setting. Journal of Community Hospital Internal Medicine Perspectives. 2018;8(1):46-48. doi: 10.1080/20009666.2017.1418110 Zhou L, Wang J, Xu G, Wang D, Wang X, Chen Z. A case of nodular episcleritis mimicking a solitary giant episcleral mass. European Journal of Ophthalmology. Published online October 16, 2021. doi: 10.1177/11206721211052879 MedlinePlus. Episcleritis. Mady R, Grover W, Butrus S. Ocular complications of inflammatory bowel disease. The Scientific World Journal. 2015;2015:e438402. doi: 10.1155/2015%2F438402 Merola JF, Espinoza LR, Fleischmann R. Distinguishing rheumatoid arthritis from psoriatic arthritis. RMD Ppen 2018;4:e000656. doi: 10.1136/rmdopen-2018-000656 Vingopoulos F, Karagiotis T, Palioura S. Bilateral interstitial keratitis, erythema nodosum and atrial fibrillation as presenting signs of polyarteritis nodosa. American Journal of Ophthalmology Case Reports. 2020;18:100619. doi: 10.1016/j.ajoc.2020.100619 Pasadhika S, Rosenbaum JT. Ocular sarcoidosis. Clinics in Chest Medicine. 2015;36(4):669-683. doi: 10.1016/j.ccm.2015.08.009 Zuber TJ, Pearlstein MV, Hwang CJ, Eftekhari K, Lugo‐Somolinos A, Googe PB. Periorbital swelling and episcleritis may be a sign of cutaneous lupus erythematosus. Clin Case Rep. 2019;7(7):1422-1425. doi: 10.1002/ccr3.2247 Bacchiega ABS, Balbi GGM, Ochtrop MLG, de Andrade FA, Levy RA, Baraliakos X. Ocular involvement in patients with spondyloarthritis. Rheumatology. 2017;56(12):2060-2067. doi: 10.1093/rheumatology/kex057 Salama A, Elsheikh A, Alweis R. Is this a worrisome red eye? Episcleritis in the primary care setting. Journal of Community Hospital Internal Medicine Perspectives. 2018;8(1):46-48. doi: 10.1080/20009666.2017.1418110 Salama A, Elsheikh A, Alweis R. Is this a worrisome red eye? Episcleritis in the primary care setting. Journal of Community Hospital Internal Medicine Perspectives. 2018;8(1):46-48. doi: 10.1080/20009666.2017.1418110 By Troy Bedinghaus, OD Troy L. Bedinghaus, OD, board-certified optometric physician, owns Lakewood Family Eye Care in Florida. He is an active member of the American Optometric Association. 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