Infection of sclera proper

Demographics:

• Mean age 40 – 60
• Female > Male
• Bilateral in 50% of cases

Etiology:

• In 60% of cases episcleritis is associated with underlying systemic disorder of infection (most commonly RA but also SLE, polymyositis, Wegner Granulomatosis and gout.)
• May also be idiopathic

Clinical Features:

• Subacute onset of symptoms
• Severe deep boring eye pain that is exacerbated by eye movement and palpitation. May radiate to the rest of the face.
• Eye redness
• Photophobia
• Loss of vision
• Fixed scleral nodules (nodular scleritis)
• Scleral thinning may appear as violet/blue discoloration