Episcleritis is an inflammatory condition affecting the tissue between the conjunctiva (the membrane that lines the inside of the eyelid) and the sclera (the white part of the eye). The red appearance of episcleritis looks similar to pink eye (conjunctivitis). Wilmer Eye Institute ophthalmologist Meghan Berkenstock explains what you should know about episcleritis.

Episcleritis Causes

There is no known cause of episcleritis, but it can be associated with an underlying inflammatory or rheumatologic condition such as:

• Rosacea
• Lupus
• Rheumatoid arthritis

Other conditions that may result in episcleritis include:

• Psoriatic arthritis
• Sarcoidosis
• Ankylosing spondylitis
• Polyarteritis nodosa
• Inflammatory bowel disease
• Ulcerative colitis
• Crohn’s disease

Episcleritis Symptoms

There are two types of episcleritis, and the symptoms may differ based on the form.

Common symptoms of both forms of episcleritis include:

• Redness  
• Mild soreness or discomfort
• Tearing
• Light sensitivity

These common symptoms do not affect vision, and they can go away on their own after several weeks.

Simple episcleritis is the most common form. Redness and inflammation of the eye lasts about seven to 10 days, and symptoms can remain longer if the episcleritis is a result of another systemic condition.

With nodular episcleritis, small bumps may develop in the center of the eye. Typically, nodular episcleritis is more painful and may be associated with a systemic disease.

Episcleritis vs. Scleritis

Episcleritis and scleritis are similar regarding appearance and symptoms. However, scleritis is usually much more painful and can lead to vision loss due to progressive inflammation of the eye tissues. It can also result in other morbidity and even death if the patient has an underlying collagen vascular disease. Episcleritis is a more superficial inflammation that can be treated with topical medications, such as nonsteroidal eyedrops.

Episcleritis Diagnosis

Diagnosis of episcleritis is made by an eye doctor through a comprehensive eye exam.

When episcleritis is suspected, an ophthalmologist will examine the patient with a slit lamp. Using a bright and narrow slit beam, nodular episcleritis can be distinguished from scleritis. Specific tests can also help determine whether the patient has episcleritis, scleritis or anther condition.

Episcleritis Treatment

Episcleritis generally clears up without treatment within three weeks. However, a doctor can provide treatments to help speed the recovery, such as:

• A cold compress that can be used three to four times daily
• Lubricating eyedrops
• Topical corticosteroids that can be used several times daily
• Oral anti-inflammatory medication