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Episcleritis
I notice that I had redness in my left eye. I went to the eye doctor and he examine the eye and stated that I had episcleritis. The first two weeks I was put on anti-inflammatory drops, which did not help. This past week I was put on Prednisolone and over the counter ibuprofen and it has help tremendously. However, I still have just a little redness. Should I be worried?
MEDICAL PROFESSIONAL
Episcleritis does not harm the eye health or vision, although it can be uncomfortable and recurrent. Short-term steroid eye drops and oral NSAIDs such as Ibuprofen help. Occasionally we are able to determine an underlying systemic cause, but 90% are usually without known systemic association. The residual redness will go away, and you should do quite well.
Episcleritis is a self-limiting disease producing little or no permanent damage to the eye. Therefore, many, if not most, patients with episcleritis will not require any treatment. However, some patients with mild symptoms demand treatment and may benefit from the use of artificial tears.
Occasionally, a clear history of an exogenous sensitization can be obtained, and removal of this agent will prevent recurrent attacks.
Ocular therapy
Simple episcleritis often requires no treatment. Artificial tears are useful for patients with mild-to-moderate symptoms. Patients with severe or prolonged episodes may require artificial tears and/or topical corticosteroids.
Nodular episcleritis is more indolent and may require local corticosteroid drops or anti-inflammatory agents.
Topical ophthalmic 0.5% prednisolone, 0.1% dexamethasone, or 0.1% betamethasone daily may be used.
Systemic therapy
If nodular episcleritis is unresponsive to topical therapy, systemic anti-inflammatory agents may be useful.
Flurbiprofen (100 mg tid) is usually effective until inflammation is suppressed.
If there is no response to flurbiprofen, indomethacin should be used; 100 mg daily and decreased to 75 mg when there is a response.
Many patients who do not respond to one nonsteroidal anti-inflammatory agent (NSAID) may respond to another NSAID.
Occasionally, a clear history of an exogenous sensitization can be obtained, and removal of this agent will prevent recurrent attacks.
Ocular therapy
Simple episcleritis often requires no treatment. Artificial tears are useful for patients with mild-to-moderate symptoms. Patients with severe or prolonged episodes may require artificial tears and/or topical corticosteroids.
Nodular episcleritis is more indolent and may require local corticosteroid drops or anti-inflammatory agents.
Topical ophthalmic 0.5% prednisolone, 0.1% dexamethasone, or 0.1% betamethasone daily may be used.
Systemic therapy
If nodular episcleritis is unresponsive to topical therapy, systemic anti-inflammatory agents may be useful.
Flurbiprofen (100 mg tid) is usually effective until inflammation is suppressed.
If there is no response to flurbiprofen, indomethacin should be used; 100 mg daily and decreased to 75 mg when there is a response.
Many patients who do not respond to one nonsteroidal anti-inflammatory agent (NSAID) may respond to another NSAID.
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