Episcleritis Dr Rob Hicks The white wall of the eye, called the sclera, is the eye's strong protective outer coat. It's covered by the thin episclera, which contains many blood vessels and provides the sclera with nutrients. When this becomes inflamed, it's called episcleritis.

In this article

What causes it? What are the symptoms?

Who's affected? How is it treated?

Episcleritis is common, but its cause is usually unknown. Infection isn't present, although in some cases episcleritis is associated with inflammatory medical conditions such as rheumatoid arthritis, inflammatory bowel disease and lupus.

It may also be associated with conditions such as gout and herpes simplex infection, so when episcleritis occurs it's important to make sure these conditions aren't a factor.

On rare occasions, it may become apparent that external substances, such as chemicals, are responsible for an attack.

When someone develops episcleritis, their eye (or eyes) appears red and may feel sore, tender and uncomfortable. In this respect, it's similar to conjunctivitis (inflammation of the conjunctiva, which covers the episclera). But unlike conjunctivitis, episcleritis doesn't cause a discharge, although watering may occur. Those affected may also find they become sensitive to bright light.

It comes in two forms: simple and nodular.

Simple episcleritis is characterised by intermittent bouts of inflammation that occur every couple of months and last between one and two weeks.

Some people report that these bouts are more likely to affect them in the spring and autumn, and although triggers often remain unidentified, some people find that stress or hormonal changes kick off the process.

Nodular episcleritis causes longer bouts of inflammation that are more painful than simple episcleritis. This type is more often associated with underlying medical conditions such as rheumatoid arthritis.

Episcleritis is more likely to affect people in their 30s and 40s, and women are more likely to be affected than men.

Fortunately, episcleritis usually resolves within one or two weeks without the need for treatment. It's also reassuring for those who experience the condition to be told it doesn't develop into a more serious problem.

Chilled artificial tears can be used to soothe sore eyes and reduce mild inflammation. For more severe or prolonged inflammation, treatment with corticosteroid eye drops or anti-inflammatory medication is recommended.

For those who find that exposure to light makes their eyes feel uncomfortable, wearing sunglasses may help.

This article was last medically reviewed by Dr Rob Hicks in February 2008