eMedicine Specialties > Ophthalmology > Sclera
Episcleritis: Differential Diagnoses & Workup
Updated: Jun 18, 2009
- Overview
- Differential Diagnoses & Workup
- Treatment & Medication
- Follow-up
Differential Diagnoses
Conjunctivitis, Viral
Keratoconjunctivitis, Superior Limbic
Scleritis
Workup
Laboratory Studies
- All patients should undergo a thorough history, including a review of systems. Results of this review and findings from the physical examination are used to determine the need for specific laboratory studies. In most patients with mild self-limited disease, laboratory studies are not useful.
- Some patients with an unremarkable review of systems may benefit from a limited workup. This includes patients with nodular episcleritis or those with severe and recurrent/persistent simple episcleritis. Useful laboratory studies in this group of patients include serum uric acid, complete blood count with differential, antinuclear antibody, rheumatoid factor, erythrocyte sedimentation rate, Venereal Disease Research Laboratory (VDRL) test, fluorescent treponemal antibody absorption (FTA-ABS) test, and chest x-ray.
Histologic Findings
Histologic findings include nongranulomatous inflammation with perivascular infiltrates and vascular dilatation.
More on Episcleritis |
| Overview: Episcleritis |
Differential Diagnoses & Workup: Episcleritis |
| Treatment & Medication: Episcleritis |
| Follow-up: Episcleritis |
| References |
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References
Boniuk M. The ocular manifestations of ophthalmic vein and aseptic cavernous sinus thrombosis. Trans Am Acad Ophthalmol Otolaryngol. Nov-Dec 1972;76(6):1519-34. [Medline].
Foster CS, Maza MS. The Sclera. Springer-Verlag; 1994:96-102.
Lim L, Suhler EB, Smith JR. Biologic therapies for inflammatory eye disease. Clin Experiment Ophthalmol. May-Jun 2006;34(4):365-374. [Medline].
Lin CP, Shih MH, Su CY. Scleritis. Surv Ophthalmol. May-Jun 2006;51(3):288-9; author reply 289. [Medline].
Minas TF, Podos SM. Familial glaucoma associated with elevated episcleral venous pressure. Arch Ophthalmol. 1968;80:202-213. [Medline].
Roy FH. Ocular Differential Diagnosis. Vol 1. 7th ed. Baltimore: Williams & Wilkins; 2002.
Watson PG. Episcleritis. In: Current Ocular Therapy. 5th ed. 809.
Watson PG, Hayreh SS. Scleritis and episcleritis. Br J Ophthalmol. 1976;60:163-192. [Medline].
Watson PG, Hazelman BL. The Sclera and Systemic Disorders. Philadelphia: WB Saunders; 1976.
Williams CP, Browning AC, Sleep TJ. A randomised, double-blind trial of topical ketorolac vs artificial tears for the treatment of episcleritis. Eye. Sep 2004;[Medline].
Further Reading
Keywords
simple episcleritis, nodular episcleritis, episcleral tissue, inflammation, conjunctiva, sclera
Differential Diagnoses & Workup: Episcleritis