What Is Episcleritis?

Redness in your eye can result from a number of things, from allergies to pinkeye or simply being really tired. One common cause is episcleritis, a condition that isn’t harmful and often goes away on its own.

What Is Episcleritis?

It’s an inflammation of the episclera, a thin layer of clear tissue on top of the white part of your eye, or sclera. This is the layer between the thin “skin” of the eye and the tough wall of the eyeball.

When the tiny blood vessels in the episclera get irritated or inflamed, they make your eye look red or bloodshot. It usually happens in just one eye but can affect both.

Though the redness may look like conjunctivitis, or pinkeye, there’s no goopy discharge.

Types

There are two types:

Simple. This is the most common. It has two subtypes:

  • Sectoral. The redness appears over part of your eye.
  • Diffuse. The redness appears over all of it.

Nodular. This is when a tiny bump (or nodule) forms on your eye. This kind tends to cause more discomfort.

Causes and Risk Factors

Experts don’t know exactly what causes it. In most cases, no specific cause can be found. About one-third of people who have it have a condition that affects their entire body (doctors call this a systemic disorder), such as:

Other causes are:

Certain things make people more likely to get it:

  • Gender. It affects women slightly more often than men.
  • Age. It can affect children, but it’s most common in adults, especially those between 40 and 50.
  • Infection. Rarely, infections with certain types of bacteria, fungi, or viruses can be a cause. The varicella virus, which causes shingles, may be a factor in some cases.
  • Cancer . In extremely rare cases, episcleritis has been linked to T-cell leukemia and Hodgkin’s lymphoma.

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Symptoms

Often, eye redness is the only symptom. But you might also notice:

  • Irritation or burning
  • Light sensitivity

Episcleritis doesn’t normally hurt. So if your eye is sore or painful, you may have something else. It doesn’t usually affect your vision or cause permanent damage to your eyes.

If you’ve had it before, it can come back. It can switch from eye to eye, but it often repeats in the same eye. If you get it in both eyes, it may come back that way.

Diagnosis

Your optometrist or ophthalmologist will make your diagnosis. They may use a slit lamp -- a device that shines light into your eye. They also may use eye drops that help them see which layer of the eye is red.

Treatment

Usually, simple episcleritis will clear up on its own in a week to 10 days. An eye doctor can give or prescribe lubricating eye drops to soothe the irritation and redness. They also may prescribe a nonsteroidal anti-inflammatory drug (or NSAID), such as ibuprofen. It can come in pill form or as a cream you apply to your eyes.

At home, cold compresses can help relieve irritation. The nodular type also should clear up on its own, but it may take a little longer and might cause a little more discomfort.

If it keeps coming back, your eye doctor may order blood work or other lab tests to check for other medical issues.

WebMD Medical Reference Reviewed by Alan Kozarsky, MD on December 27, 2018

Sources

SOURCES:

American Academy of Ophthalmology: “Episcleritis.”

The Ocular Immunology and Uveitis Foundation: “Episcleritis.” 

Johns Hopkins Medicine Wilmer Eye Institute: “Episcleritis.”

The College of Optometrists: “Episcleritis.”

Journal of Community Hospital Internal Medicine Perspectives: “Is this a worrisome red eye? Episcleritis in the primary care setting.”

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