Episcleritis

Jump to navigation Jump to search

WikiDoc Resources for Episcleritis

Articles

Most recent articles on Episcleritis

Most cited articles on Episcleritis

Review articles on Episcleritis

Articles on Episcleritis in N Eng J Med, Lancet, BMJ

Media

Powerpoint slides on Episcleritis

Images of Episcleritis

Photos of Episcleritis

Podcasts & MP3s on Episcleritis

Videos on Episcleritis

Evidence Based Medicine

Cochrane Collaboration on Episcleritis

Bandolier on Episcleritis

TRIP on Episcleritis

Clinical Trials

Ongoing Trials on Episcleritis at Clinical Trials.gov

Trial results on Episcleritis

Clinical Trials on Episcleritis at Google

Guidelines / Policies / Govt

US National Guidelines Clearinghouse on Episcleritis

NICE Guidance on Episcleritis

NHS PRODIGY Guidance

FDA on Episcleritis

CDC on Episcleritis

Books

Books on Episcleritis

News

Episcleritis in the news

Be alerted to news on Episcleritis

News trends on Episcleritis

Commentary

Blogs on Episcleritis

Definitions

Definitions of Episcleritis

Patient Resources / Community

Patient resources on Episcleritis

Discussion groups on Episcleritis

Patient Handouts on Episcleritis

Directions to Hospitals Treating Episcleritis

Risk calculators and risk factors for Episcleritis

Healthcare Provider Resources

Symptoms of Episcleritis

Causes & Risk Factors for Episcleritis

Diagnostic studies for Episcleritis

Treatment of Episcleritis

Continuing Medical Education (CME)

CME Programs on Episcleritis

International

Episcleritis en Espanol

Episcleritis en Francais

Business

Episcleritis in the Marketplace

Patents on Episcleritis

Experimental / Informatics

List of terms related to Episcleritis

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Rohan Bir Singh, M.B.B.S.[2]

Synonyms and keywords:

Overview

Episcleritis is an acute, recurrent, benign inflammatory condition of the loose connective tissue lying superficial to the sclera and deeper to the conjunctiva.

Historical Perspective

[Disease name] was first discovered by [name of scientist], a [nationality + occupation], in [year]/during/following [event].

The association between [important risk factor/cause] and [disease name] was made in/during [year/event].

In [year], [scientist] was the first to discover the association between [risk factor] and the development of [disease name].

In [year], [gene] mutations were first implicated in the pathogenesis of [disease name].

There have been several outbreaks of [disease name], including -----.

In [year], [diagnostic test/therapy] was developed by [scientist] to treat/diagnose [disease name].

Classification

Inflammation of the episclera is classified by its location and severity using the system devised by Watson.[1]

Classification of Episcleritis
Episcleritis
  • Diffuse
  • Nodular

Pathophysiology

The exact pathogenesis of [disease name] is not fully understood.

OR

It is thought that [disease name] is the result of / is mediated by / is produced by / is caused by either [hypothesis 1], [hypothesis 2], or [hypothesis 3].

OR

[Pathogen name] is usually transmitted via the [transmission route] route to the human host.

OR

Following transmission/ingestion, the [pathogen] uses the [entry site] to invade the [cell name] cell.

OR


[Disease or malignancy name] arises from [cell name]s, which are [cell type] cells that are normally involved in [function of cells].

OR

The progression to [disease name] usually involves the [molecular pathway].

OR

The pathophysiology of [disease/malignancy] depends on the histological subtype.

Causes

Disease name] may be caused by [cause1], [cause2], or [cause3].

OR

Common causes of [disease] include [cause1], [cause2], and [cause3].

OR

The most common cause of [disease name] is [cause 1]. Less common causes of [disease name] include [cause 2], [cause 3], and [cause 4].

OR

The cause of [disease name] has not been identified. To review risk factors for the development of [disease name], click here.

Differentiating Episcleritis from Other Diseases

[Disease name] must be differentiated from other diseases that cause [clinical feature 1], [clinical feature 2], and [clinical feature 3], such as [differential dx1], [differential dx2], and [differential dx3].

OR

[Disease name] must be differentiated from [[differential dx1], [differential dx2], and [differential dx3].

Epidemiology and Demographics

Episcleritis is overwhelmingly a disease of adults affecting a wide range of age groups; pediatric age group involvement is rare. The sex distribution varies between published series but those series that describe an association with rheumatic diseases tend to have a female preponderance. Episcleritis is uncommon and the exact etiology of episcleritis is difficult to ascertain. Diffuse episcleritis is more common than nodular episcleritis.The majority of patients with episcleritis have mild evanescent disease that usually does not require ophthalmological intervention and treatment.

Risk Factors

There are no established risk factors for [disease name].

OR

The most potent risk factor in the development of [disease name] is [risk factor 1]. Other risk factors include [risk factor 2], [risk factor 3], and [risk factor 4].

OR

Common risk factors in the development of [disease name] include [risk factor 1], [risk factor 2], [risk factor 3], and [risk factor 4].

OR

Common risk factors in the development of [disease name] may be occupational, environmental, genetic, and viral.

Screening

There is insufficient evidence to recommend routine screening for [disease/malignancy].

OR

According to the [guideline name], screening for [disease name] is not recommended.

OR

According to the [guideline name], screening for [disease name] by [test 1] is recommended every [duration] among patients with [condition 1], [condition 2], and [condition 3].

Natural History, Complications, and Prognosis

Episcleral inflammation adjacent to the cornea can lead to mild peripheral corneal infiltrate or oedema, and the peripheral cornea can be left thinned or vascularized. Recurrent attacks of episcleritis over a long time can cause mild scleral thinning, which is of no consequence to the integrity of the eye. The most common complications seen in patients with episcleritis are related to the use of long-term topical corticosteroids. The use of long-term topical corticosteroids can lead to Cataract, ocular hypertension, and steroid-induced glaucoma. Rarely, topical corticosteroids may also induce herpetic keratitis. These treatment-related complications are the commonest causes of visual loss in patients with episcleritis.

Diagnosis

When diagnosed clinically, a small number of serological tests to ascertain associative autoimmune diseases like rheumatoid arthritis or systemic lupus erythematosus may be useful.

Anterior segment fluorescein angiography in episcleritis reveals a normal vascular pattern but the flow rate is generally faster than normal and the whole transit of dye may be completed within two to three seconds.

High definition anterior segment ultrasound helps in differentiating episcleritis from scleritis but is rarely necessary clinically

Treatment

Medical Therapy

Episcleritis is a self-limiting disease, thus it doesn't frequently require any treatment. If the symptoms are severe to require treatment, topical steroids generally provide rapid symptomatic relief and have proven benefit over topical non-steroidal anti-inflammatory treatment and topical lubricants.

Systemic treatment with oral non-steroidal antiinflammatory drugs such as cyclo-oxygenase inhibitors, may be required for episcleritis. In general any systemic disease should be treated on its merits and the episcleritis treated as necessary. Any local ocular disease, such as acne rosacea, atopy, or keratoconjunctivitis sicca that may be causing or contributing to the episcleritis, should be treated aggressively.

References

  1. Watson PG, Hayreh SS (1976). "Scleritis and episcleritis". Br J Ophthalmol. 60 (3): 163–91. PMC 1042706. PMID 1268179.


Template:WikiDoc Sources