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What is Episcleritis?

Herpes Zoster, sjogren's syndrome, SLE

After only a few hours of sleep due to a project at work, 43-year-old Kyle wasn’t overly concerned when he noted that the white part of his left eye had turned pink overnight. He assumed it was due to eye strain. However, the following day, he scheduled an emergency appointment with an ophthalmologist when pink deepened into purple and the eye hurt. The doctor diagnosed him as suffering from episcleritis.

What is Episcleritis?

Doctors consider this condition a fairly common disorder of the eye. According to MedlinePlus, episcleritis in an inflammation that strikes the episclera without any accompanying infection. The sclera is the portion of the eyeball that makes up its strong white wall. It consists largely of tissue fibers and is covered by a thin layer of tissue known as the episclera. This thin layer is made up of many vessels that transport blood to the sclera.

The medical community is divided on whether the sex of a patient is a predisposing factor for developing this condition. Some experts indicate it isn’t, while others suggest that as nearly three quarters of cases occur in females, eMedicine reports. The disorder most often strikes individuals in their fourth or fifth decades of life.

There are two types of episcleritis. Simple episcleritis is the more common type. These cases typically resolve in two to three weeks and usually involve bouts of moderate to severe inflammation that can recur periodically. Cases of nodular episcleritis are usually more painful than those associated with the simple type and are often associated with a systemic illness.

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Causes

Doctors are unable to find the cause of most cases of episcleritis. However, eMedicine reports that up to a third are linked to an underlying systemic condition. Among these illnesses are rheumatoid arthritis, system lupus erythematosis (SLE), inflammatory bowel disease (Crohn’s, ulcerative colitis) and other types of arthritis.

Herpes zoster, Sjogren syndrome, syphilis and tuberculosis all have been associated with development of this eye inflammation. Other reported culprits include gout, certain allergies, chemicals and foreign bodies in the eye. Even fungi and parasites have taken their share of the blame.

Among the rarest conditions associated with episcleritis are T-cell leukemia, Wiskott-Aldrich syndrome, insect bite granuloma and progressive hemifacial atrophy. Other uncommon causes include Sweet syndrome, dermatomyositis, adrenal cortical insufficiency and malpositioned Jones tube.

Symptoms and Treatment

Most patients know something is wrong when the white portion of their eye turns pink or purple. They typically experience pain and tenderness, tearing in the affected eye and sensitivity to light.

Doctors are usually able to diagnose episcleritis during a standard eye exam, without resorting to any special tests. Fortunately, most episodes clear up without treatment in a week or two. In order to relieve symptoms more quickly, doctors might prescribe corticosteroid eye drops.

While the initial pink or purple appearance of an infected eye upsets a lot of patients, most are relieved that if any treatment is required, it’s simple and short-term. For many individuals, the most troubling aspect of episcleritis is its tendency to recur, especially if linked to an underlying disease.

Sources:

http://www.nlm.nih.gov/medlineplus/ency/article/001019.htm

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http://emedicine.medscape.com/article/1228246-overview