Episclera and sclera

Diagnosis

• Presentation: acute onset of redness and mild discomfort.

• Signs: hyperaemia may be sectoral (typically interpalpebral; Fig. 8.1 ) or diffuse.

  

• Course: spontaneous improvement occurs within several days, but recurrences may occur.

Treatment: not required if mild; otherwise lubricants or a weak steroid four times daily for 1–2 weeks.

Diagnosis

• Presentation: less acute onset than simple episcleritis with redness and discomfort worsening over 2–3 days.

• Signs: (a) one or more tender interpalpebral nodules ( Fig. 8.2 ), and (b) absence of deeper scleral thickening; after several attacks, the vessels surrounding the inflamed area may become permanently dilated.

  

• Course: more prolonged than simple episcleritis.

Treatment: similar to that of simple episcleritis.