Do you sometimes feel your eyes suddenly turn red, a little uncomfortable, and burning? When you look in the mirror, you may feel a little scared when you see red threads stretching across the white part of your eye. If this has happened to you, it may be a condition called Episcleritis, which we are going to talk about today.
What is Episcleritis?
Simply put, Episcleritis is an inflammation or swelling of the episclera, a membrane inside our eye. Imagine, we have a white part of our eye, which we call the sclera . Above the sclera, like a thin membrane, and below the eyeball, there is a clear tissue called the episclera. So when the blood vessels in the episclera become swollen, enlarged, and appear red, we call it episcleritis. Most often, this occurs in one eye, but sometimes it can occur in both eyes.
Who is more likely to develop Episcleritis?
This condition can actually develop in anyone, but research has found that it is more common in women between the ages of 47 and 60 .
How common is this condition?
Although there are no exact statistics on how common it is in Sri Lanka, for example, in the United States, it is reported that about 41 out of 100,000 people develop Episcleritis per year. This means that it is not that rare.
Are there types of episcleritis?
Yes, there are two main types of Episcleritis.
- Simple Episcleritis: In this type, the redness of the eye can be limited to one area (called sectoral ) or it can be red over a large area of the eye (called diffuse ). This type of simple episcleritis can start suddenly. Doctors call this 'acute onset' . In this type, the condition may get worse over the course of about 12 hours, then improve over the next two to three days.
- Nodular Episcleritis: In this type, a swollen, raised nodule forms on the episclera. This tends to develop gradually, rather than suddenly, like the simple type.
What are the symptoms of Episcleritis?
If you have Episcleritis, you may experience symptoms like:
- Redness of the white of the eye and a slight tingling or burning sensation.
- Eye swelling .
- Tears coming from the eyes (watering) .
- Feeling uncomfortable in the eye. But it's usually not a severe pain . This is the most important thing. It just feels like a slight stinging, burning sensation.
What are the causes of episcleritis?
In most cases, no specific cause can be found for episcleritis. Doctors call this ' idiopathic ' , which means 'of unknown cause'.
However, in some cases, this condition called Episcleritis can be associated with other inflammatory diseases and immune system disorders . Some of these diseases are:
- Rheumatoid arthritis: This is an inflammatory disease of the joints. Our own immune system attacks the tissues around the joints. This affects joints on both sides of the body.
- Lupus: This is also an autoimmune disease (also called `Systemic lupus erythematosus`). It can cause swelling and pain throughout the body. It can also cause joint pain, skin problems, and problems with internal organs.
- Inflammatory bowel disease (IBD): This is a group of diseases that cause pain and swelling in the intestines. Over time, it can damage the intestinal tissue.
- Rosacea ( Rosacea ): This is a condition that mainly affects the skin of the face. The face becomes red and it is difficult to get rid of it. It can also cause problems with the eyes.
- Behçet's disease: This is a chronic condition caused by inflammation of the blood vessels (`vasculitis`).
In addition, some infections can also cause episcleritis. For example:
- Lyme disease: This is a disease caused by a bacterium (`Bacterium`). It is transmitted by ticks.
- Syphilis: This is a sexually transmitted infection (STI) that can have serious health effects.
- Herpes infections.
- Cat scratch fever / Cat scratch disease: This is an infection caused by bacteria found in cat saliva.
Sometimes doctors consider things like stress, allergies, and hormonal fluctuations as factors that can affect someone with Episcleritis. However, these are not necessarily `triggers` that cause Episcleritis.
How do you know if you have episcleritis?
Your eye care provider will perform a routine eye exam.They will be able to diagnose episcleritis. They will also ask about your health history, especially if you have any immune system diseases.
Your doctor may also need to perform additional tests, such as blood tests and/or imaging tests, to determine exactly whether you have the aforementioned immune system disease or inflammatory disease.
How is episcleritis treated?
Your doctor may prescribe eye drops containing corticosteroids or may suggest the use of nonsteroidal anti-inflammatory drugs (NSAIDs) .
When using these eye drops or NSAIDs, the symptoms quickly subside and the condition improves quickly.
Imagine, if you have episcleritis and the immune system problem mentioned earlier, your doctor will work with a rheumatologist to provide you with the full treatment you need.
What happens if you develop episcleritis? What is the outlook?
If you have Episcleritis, the outlook is usually good . That means there's nothing to worry about. However, it's common for Episcleritis to recur more than once . It can be a bit worrying.
If you have simple episcleritis, it can usually go away on its own in two to three weeks . The symptoms will quickly go away with the use of eye drops or NSAIDs.
However, when steroids are used to treat episcleritis, side effects such as glaucoma or cataracts have been reported very rarely. Therefore, it is important to take the treatment exactly as directed by your doctor.
Can the occurrence of episcleritis be reduced?
Since it is often impossible to tell what causes episcleritis, there is really no way to prevent it from occurring .
What should I do if I have episcleritis?
You can use cool compresses with a clean cloth soaked in cold water to soothe your eyes. Also, chilling your eye drops in the refrigerator will help your eyes feel better.
If your doctor agrees, you can also take NSAIDs for the discomfort and swelling.
When should you see a doctor for episcleritis?
As soon as you start to develop a condition like Episcleritis, especially if you have never had anything like this before , you should definitely see a doctor for advice.
Also, if you are not getting any relief from the things you are doing to control your episcleritis, or if the condition is getting worse, see a doctor immediately .
What is the difference between Episcleritis and Scleritis?
Although both episcleritis and scleritis cause red eyes, there are big differences between the two conditions.
Episcleritis is not a painful condition . Scleritis is a very painful condition . This is the main difference.
Also, in Episcleritis, there is no photophobia , that is, an inability to look at light. However, in Scleritis, it can be severe.
Another important thing to note is that Episcleritis does not cause vision loss . However, Scleritis can damage your vision.
Episcleritis does not cause scleritis. However, if you have scleritis, you may also have episcleritis.
What is the difference between Episcleritis and Conjunctivitis?
Episcleritis and Conjunctivitis - what we commonly call 'pink eye' - both cause red eyes and may seem similar, but there are differences between the two.
In episcleritis, the red area of the eye is limited to a limited area , rather than spreading throughout the entire eye like in other eye diseases.
Also, in eye diseases , there is excessive watering of the eyes, and there is also a discharge . But in Episcleritis , there is no discharge, and it is not a contagious disease . That is also important.
Finally, things to remember
Your eyes are very precious to you, aren't they? So, there are many times when your eyes become red and uncomfortable. However, if your eyes are red, swollen, or uncomfortable, it's best to see a doctor to find out the exact cause .
Many conditions start with redness or discomfort in the eye. Episcleritis is not a dangerous, contagious condition. However, there are other conditions that can look like episcleritis but can be more serious .
Therefore, if you have eye pain or blurred vision, definitely see a doctor . Do not self-medicate. Because the eyes are very sensitive organs.
👩🏽⚕️ Additional questions (FAQs)
💬 Is Episcleritis a contagious disease that causes 'pink eye'?
No! This is not a contagious disease (Conjunctivitis/Pink eye). This is a condition in which the very thin, transparent layer (Episclera) above the white of the eye (Sclera), but under the outermost layer (Conjunctiva), suddenly swells, causing the eye to become unusually 'dark red' (inflamed).
💬 Are your eyes red and blurry? Is this dangerous?
This is not a dangerous disease. Although episcleritis causes the eye to become very red (and bloodshot), there is no discharge, blurred vision, or severe eye pain (only a slight burning/itching may occur). Therefore, there is no need to worry about vision.
💬 What medicine should I use to get rid of this redness in my eyes?
This disease usually resolves on its own within 1 to 2 weeks without any medication. However, if there is inflammation, artificial tears/lubricants may be enough. If the disease is severe, steroid drops or NSAIDs may be prescribed as directed by a doctor.
` Episcleritis, red eye, inflammation of the eye, episclera, sclera, eye disease
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