About Dr. Atul Ursekar Expertise I am a qualified Ophthalmologist with specialty fellowship training and special interest in Vitreo-retinal diseases and surgery. I will be happy to answer most questions related to general ophthalmology and especially those related to vitreous and retinal disorders and their management. I do not practice contact lens fitting, orbital or oculoplastic surgery.
Experience I am practising ophthalmic medicine & surgery for over 12 years including specialized techniques like phacoemulsification with intraocular lens implantation, glaucoma surgery, laser photocoagulation, vitrectomy and retinal detachment surgery. I have special experience in the diagnosis and management of retinopathy of prematurity.
Question Hi, I am a 43-yr-old woman in excellent general health. I have been diagnosed with episcleritis (not sure if spelling is correct) 6 times over the last 10 years. I currently have it again and my dr. is treating it with Prednisolene drops, which are helping. This episode is the worst one. My eye has been very red and sore and it wakes me up at night. I have also been feeling a little tired and somehow think it has to do with this eye problem. I do work full time and I am a single mom, but I am accustomed to a hectic schedule. My dr. doesn't tell me alot but he has said that the root of the problem is systemic, and I am beginning to wonder what might be wrong that is causing this condition, and also if it will continue and / or get worse over the years. I had lasik surgery to correct nearsightedness 5 years ago and have great results. The epi started prior to that and I thought it might have been because of contacts, but apparently not.
Thank you for any information you can provide!
Sandy
Answer EPISCLERITIS is a benign inflammatory condition of the external eye. It is seen most commonly in young adults. Women appear to be affected slightly more often than men.
The most common type is simple episcleritis, in which there are intermittent bouts of moderate-to-severe inflammation that often recur at 1- to 3-month intervals. The episodes usually last 7-10 days, and most resolve after 2-3 weeks.
Prolonged episodes may be more common in patients with associated systemic conditions. Some patients note that episodes are more common in the spring or fall. The precipitating factor is rarely found, but attacks have been associated with stress and hormonal changes.
Episcleritis presents as a sudden onset redness in one or both eyes. Typically, you'll observe a sectoral injection of the episcleral and overlying conjunctival vessels.
Occasionally, there may be a translucent white nodule centrally within the inflamed area (nodular episcleritis).
Some patients complain of mild pain or tenderness to the affected region --- particularly upon manipulation.
Most cases of episcleritis are self-limiting, meaning that they will resolve spontaneously within two to three weeks even if the patient does not undergo treatment. Usually it produces little or no permanent damage to the eye.
However, patients who are experiencing discomfort may benefit from a regimen of topical anti-inflammatory agents and lubricants.
Typically, steroid eye drops applied will speed resolution and decrease the tenderness. You may use cold compresses and artificial tears liberally if discomfort persists.
Sunglasses may be useful for patients with sensitivity to light.
More severe cases, particularly nodular episcleritis, may require oral medications to control the inflammation.
Patients on topical steroid therapy for more than two weeks require to be monitored by their ophthalmologist.
Because of the association with systemic disorders, patients with severe presentations or more than three recurrences need to undertake a thorough medical evaluation by a physician. Additional lab tests may be ordered after a clinical exam.
