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Guilherme Mazui

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What is the Difference Between Scleritis and Episcleritis?

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Scleritis and episcleritis are two different inflammatory conditions that affect the eye. They present with some similar features but have distinct differences:

Episcleritis:

  • Inflammation of the superficial, episcleral layer of the eye.
  • Relatively common, benign, and self-limiting.
  • No identifiable cause in most cases, but some are associated with systemic inflammatory conditions.
  • Often recurrent, with attacks typically recurring every few months.
  • Nine times more common in women than men.
  • Most common in adults in their 40s and 50s.
  • Usually resolves over 7-10 days without treatment.

Scleritis:

  • Inflammation involving the sclera.
  • Severe ocular inflammation, often with ocular complications, and nearly always requires systemic treatment.
  • Occurs more commonly in older women and is usually associated with an underlying systemic disease.
  • Tends to come on more slowly and affects the deep white layer (sclera) of the eye.
  • Can spread to affect adjacent layers around the sclera, including the episclera and the cornea.
  • Requires ophthalmology consultation and steroids +/- topical antibiotics for management.

In summary, episcleritis is an inflammation of the superficial episcleral layer and is relatively common, benign, and self-limiting, while scleritis is an inflammation involving the sclera and is a severe and potentially blinding ocular condition that requires systemic treatment. Both conditions can initially look similar but have different clinical presentations and treatments.

On this page
  • What is the Difference Between Scleritis and Episcleritis?
  • Comparative Table: Scleritis vs Episcleritis

    • Comparative Table: Scleritis vs Episcleritis

    Here is a table comparing the differences between scleritis and episcleritis:

    Feature Scleritis Episcleritis
    Definition Inflammation involving the sclera, a severe ocular inflammation Inflammation of the superficial episcleral layer of the eye, relatively common and benign
    Severity Often requires systemic treatment, can lead to ocular complications Self-limiting, typically does not progress to scleritis
    Pain Significant pain, pain with eye movement, vision loss Less painful, no vision loss
    Vessel Blanching Vessels do not blanch with phenylephrine, deeper scleral vessels involved Vessels blanch with phenylephrine, superficial episcleral vessels involved
    Causes Often associated with other inflammatory diseases, such as rheumatoid arthritis Most cases have no identifiable cause, some associated with systemic inflammatory conditions
    Epidemiology Estimated incidence of 41.0 per 100,000 per year; prevalence of 52 Incidence estimated at 41.0 per 100,000 per year; prevalence of 52
    Treatment Ophthalmology consultation, steroids, and possibly topical antibiotics Ophthalmology consultation when further investigation is required; usually self-limited and does not require acute treatment
    Types Nodular, diffuse, necrotizing with inflammation, and necrotizing without inflammation Simple (diffuse or nodular)

    Both scleritis and episcleritis are clinical diagnoses, and a thorough examination is essential to differentiate between the two conditions.

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    Guilherme Mazui

    Guilherme Mazui is graduated in journalism from the Federal University of Minas Gerais (UFMG) and a master's degree in Communication from the University of São Paulo (USP). In addition, he has experience in advertising writing and has worked as a content editor in several companies.