EPISCLERITIS

• Episcleritis is a benign recurrent inflammation of the episclera, involving the overlying Tenon's capsule but not the underlying sclera
• It typically affects young adults, being twice as common in women than men

• Idiopathic
• Systemic diseases - Gout, Rosacea, Psoriasis and Connective tissue diseases
• Hypersensitivity reaction to endogenous tubercular or streptococcal toxins
• Less common causes – Bacterial / viral infection drug reaction e.g. bisphosphonates

Symptoms

• Acute onset of symptoms
• Redness
• Mild ocular discomfort described as gritty, burning or foreign body sensation
• Mild photophobia and lacrimation

Two clinical types of Episcleritis are : Simple and Nodular

Simple Episcleritis

• Characterised by sectorial (occasionally diffuse) inflammation of episclera
• The engorged episcleral vessels are large and run in radial direction beneath the conjunctiva

Nodular Episcleritis

• Characterised by a pink or purple flat nodule surrounded by injection, usually situated 2–3 mm away from the limbus
• Usually occurs in patients with underlying systemic diseases

• Slit Lamp Examination -Engorged episcleral vessels
• Laboratory tests- Serum uric acid etc to find associated systemic diseases

• Topical NSAIDs
• Topical mild corticosteroid eye drops
• Topical artificial tears g., 0.5% Carboxy Methylcellulose
• Cold compresses
• Systemic non-steroidal anti-inflammatory drugs

Ayurvedic Treatment

Internal medicines

• Panchatikthaka Kashaya
• Guduchyadi kashaya
• Patoladi kashaya
• Guggulu thikthka Kashaya
• Kaisora guggulu
• Patoladi Gritha

External procedures

• Purambada - Mukkadi gutika + milk in swelling of eyelids
• Aschotana - Chandanadi Varthi in redness
• Seka - Yashti+ Darvi+ Lodhra Kashaya
• Jaloukavacharana- forehead (repeatedly)