Scleritis and Episcleritis

When people see a red or pink eye, they usually think of conjunctivitis. However, the white part of the eye is made up of several layers. The outer layer is the conjunctiva; when this layer is inflamed, the condition is called conjunctivitis. The next layer down is called the episclera which is followed by the sclera. The episclera is a type of tissue that is more dense than the conjunctiva, but not as dense as the deeper sclera which is the structure of the eye. When these layers are inflamed, you get episcleritis and scleritis. It usually takes an eye doctor or ophthalmologist to determine the difference between conjunctivitis, episcleritis and scleritis. This is important because conjunctivitis is usually from an infection, but episcleritis and scleritis are usually autoimmune. Autoimmune means that the body is attacking it's own tissue with the immune system. Episcleritis can be associated with more severe conditions, but usually it is a relatively minor condition that readily responds to treatment. It usually is irritating, but not particularly painful. There is not much discharge usually and often only one eye is involved at a time. It may feel scratchy or slightly painful, but the symptoms often respond to just artificial tears. The redness will often be on just one side of the eye also. Scleritis is often associated with a more serious condition such as rheumatoid arthritis, lupus, wegener's granulomatosis, scleroderma, and other "connective tissue diseases." It can also be associated with tuberculosis and syphilis although that is less likely. The color of the eye with scleritis tends to be more red, and almost a purple hue to the coloration. There is often severe eye pain or a severe headache and the vision may also be blurry. One eye or both eyes may be affected at the same time. The treatments for episcleritis are usually drops such as artificial tears, steroid eye drops, or motrin-like eye drops. Scleritis usually requires blood work to rule out more serious conditions, and it is usually treated with prednisone pills or steroid injections. In more mild cases, it can be treated with ibuprofen. If you are in Central Texas, the Austin, Georgetown, or Temple, Texas areas and you think you may have this condition. Please call 512-686-1224 to schedule an appointment with Dr. Aaker.