What is it about ?
The eye consists of several parts. The outer part is the sclera or sclera, it is the white of the eye. A thin protective membrane covers it, it is the conjunctiva. In the front part of the eye, the sclera extends into a transparent part, the cornea. The cornea covers the iris and the pupil. The light is transmitted to the inside of the eye through the cornea.
The white part forms the wall of the eye and has three layers: the outer lining (conjunctiva), the sclera on the inside (sclera), and the connective tissue layer in between (episclera).
Inflammation of this middle layer of the white of the eye is called episcleritis. It is a rare disease, since inflammation is more common in places with a lot of blood vessels and there are hardly any in the episclera. In addition, the episclera is protected by the outer mucous layer (conjunctiva). Inflammation usually occurs from the inside out, without infection from bacteria or viruses. It is more common in people with connective tissue disease (eg rheumatoid arthritis). Episcleritis can be associated with an allergy.
Where and how often?
Episcleritis occurs mostly at a young to middle age, between 20 and 50 years old. It affects both eyes almost 1 in 2: sometimes at the same time and sometimes in turn.
How to recognize it?
Episcleritis usually doesn’t cause a lot of complaints. We can sometimes feel a slight pain, a little irritation or a feeling of sand in the eye. Sight is rarely affected. Eye movements can be painful.
Depending on the extent of the inflammation, a nodular form, a sectoral form and a diffuse form are distinguished. In its nodular form, a red bump appears on the white of the eye. In the sectoral form, the redness spreads to the edge of the iris. In diffuse inflammation, the redness can affect all of the white part of the eye.
Episcleritis heals well, but there may be a scar on the sclera.
How is the diagnosis made?
It is important for your doctor to distinguish between episcleritis and other eye inflammations, such as inflammation of the sclera (scleritis) and inflammation of the conjunctiva (conjunctivitis).
What can you do ?
Usually, episcleritis resolves spontaneously within a few days, at most weeks, without leaving a mark. Avoid heat and drafts as these environments slow down healing. Have your eyes checked by an ophthalmologist; indeed, it is always possible that another condition is at the origin of your problem.
What can your doctor do?
The doctor may prescribe eye drops and anti-inflammatory tablets. If the episcleritis persists, the general practitioner will refer you to the ophthalmologist to consider the need for cortisone treatment.
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