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Episcleritis
Key Messages
Scope
Episcleritis is a common, benign, self-limiting inflammatory disease affecting the episclera, the loose connective tissue between the conjunctiva and sclera. It causes mild discomfort. It is usually idiopathic and only rarely associated with systemic disease (E.G. Rheumatoid arthritis).
Signs and Symptoms
- Mild ache/soreness of the eye often worse with eye movement
- Mildly tender to touch
- Red eye
- Segmental or focal redness which can be raised (nodular)
Consider lubricants to ease tired/’red eyes’ (11.8.1 Tear deficiency, ocular lubricants, and astringents) – please note that most products can be purchased over the counter at a cost less than the prescription charge
Consider oral analgesia for pain relief (4.7.1 Non-opioid analgesics and compound analgesic preparations) – please note many analgesic containing products are cheap to buy and are readily available over the counter along with advice from pharmacies.
Referral Criteria
Suspected scleritis (if redness is deep or if pain is severe e.g. wakes patient at night) Refer Urgently
No significant improvement after 2 weeks of treatment. Refer Routinely
Referral Instructions
e-Referral Service Selection
Specialty: Ophthalmology
Clinic Type: Not Otherwise Specified
Service: DRSS-Eastern and Northern-Ophthalmology-Optom Only-Devon ICB- 15N
Referral Form
Pathway Group
This guideline has been signed off by NHS Devon
Publication date: June 2022
