Episcleritis

If you have episcleritis your symptoms may include:

• Redness of the eyes (this is often the only symptom)
• Mild soreness or a gritty feeling in the eyes,
• Swelling
• Light sensitivity

There are two main types of episcleritis. The most common is called ‘simple’ episcleritis, which can be broken down into two further subtypes. ’Sectoral’ means the redness appears over part of your eye. ‘Diffuse’ is when you have redness all over your eye.

The second type is called nodular episcleritis. This is when a tiny bump grows on your eye which can be uncomfortable.

Experts aren’t sure about the exact cause of episcleritis. It can appear or flare up if you haven’t been getting enough sleep and rest, have been reading or using screens a lot, or you’re somewhere dusty or dry.

In very rare cases it can be caused by underlying inflammation in your body. If you are experiencing severe, recurring episodes, your doctor may run blood tests to check if this could be the case.

You are more likely to experience episcleritis if:

• You’re a woman. Women are affected slightly more often than men
  • You’re an adult. You can get it at any age, but it affects adults more often especially in the 40-50 age group
  • You have an infection in your body
  • You have cancer. Some cancers can cause episcleritis
  • You have an underlying inflammatory disease such as:¹
    • rheumatoid arthritis
      • rosacea
      • lupus
      • Crohn’s disease

Episcleritis often goes away by itself so you might not need treatment. However, if it persists, there are different treatment options available to treat it.

Episcleritis eye treatments can include eye drops or ointments to help lubricate the eye. A short course of steroid drops might be prescribed if symptoms don’t go away. This is more common for the nodular type.²

If episcleritis does not settle after a week, or if the pain becomes worse and your vision is affected, you should see your doctor or your optometrist in case you have scleritis.

If you have eye redness along with deep pain in or around your eye you could have a rarer, more serious condition called scleritis. You may also have a watery eye, blurred vision, and experience sensitivity to light. The pain may be worse when you move your eye, and the eye can feel painful to touch. The white of your eye may also have a blueish tinge.

Scleritis affects the sclera, the deeper white layer of your eye and sometimes can spread to deeper layers. It tends to develop more slowly than episcleritis affecting one or both eyes.

Scleritis can damage parts of your eye which can affect vision permanently. If you think you may have scleritis you should see your doctor urgently. Fast diagnosis and treatment is essential to preventing long term damage to your eyesight.

There are two main types of scleritis:³

• Anterior scleritis: This is when the front of your sclera is inflamed
• Posterior scleritis: This is when the back of your sclera is inflamed. It can be painful to move your eye even if your eye may not be visibly red. It is much rarer but can lead to serious eye problems

Scleritis treatment depends largely on the type you have, the cause and how you respond to treatment.

The first option is medication to reduce the inflammation in the eye, the main cause of the eye pain. This is usually done through nonsteroidal anti-inflammatory drugs (NSAID). This tends to be effective for most people.⁴

For others, especially those suffering from underlying inflammatory diseases, stronger treatments like steroids tablets may be necessary.

In very rare cases where the sclera is thinning, surgery might be necessary.⁵

If you have eye redness along with a white gloopy discharge in your eyes, it could be another condition such as conjunctivitis, as episcleritis does not cause discharge in your eyes.

Conjunctivitis is also a common condition and can be contagious. You will need to be careful with hygiene, for example, by washing hands frequently and avoiding sharing towels. Mild episodes may clear up on their own.

You may need antibiotic eye drops or ointment if you experience pain, sensitivity to light, blurred vision or your symptoms don’t improve or get worse.⁶ Please contact your doctor or your optometrist if you think you may have conjunctivitis.

If you need to find a local pharmacy or would like to read more about how prescriptions for episcleritis work, please head over to the NHS website for more information.

1. https://www.hopkinsmedicine.org/wilmer/conditions/episcleritis.html

2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5804772/

3. https://www.webmd.com/eye-health/what-is-episcleritis

4. https://www.imperial.nhs.uk/-/media/website/patient-information-leaflets/ophthalmology/scleritis-final.pdf?rev=61c92c3c6921419d867cda1b35c493fb&sc_lang=en

5. https://www.healthline.com/health/scleritis#treatment

6. https://www.cdc.gov/conjunctivitis/about/treatment.html#:~:text=Your%20doctor%20may%20prescribe%20an,With%20discharge%20(pus)