Episcleritis: Difference between revisions
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==Diagnosis== | ==Diagnosis== | ||
When diagnosed clinically, a small number of | |||
serological tests | serological tests to ascertain associative autoimmune diseases like [[rheumatoid arthritis]] or [[Systemic lupus erythematosus|systemic lupus | ||
erythematosus may be useful. | erythematosus]] may be useful. | ||
Anterior segment fluorescein angiography in episcleritis reveals | Anterior segment fluorescein angiography in episcleritis reveals | ||
a normal vascular pattern but the flow rate is generally faster than | a normal vascular pattern but the flow rate is generally faster than | ||
normal and the whole transit of dye may be completed within two | normal and the whole transit of dye may be completed within two | ||
to three seconds. | to three seconds. | ||
High definition anterior segment ultrasound helps in differentiating episcleritis from scleritis but is rarely | |||
necessary clinically | necessary clinically | ||
Revision as of 16:48, 3 March 2018
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WikiDoc Resources for Episcleritis |
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Articles |
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Most recent articles on Episcleritis Most cited articles on Episcleritis |
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Media |
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Powerpoint slides on Episcleritis |
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Evidence Based Medicine |
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Clinical Trials |
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Ongoing Trials on Episcleritis at Clinical Trials.gov Clinical Trials on Episcleritis at Google
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Guidelines / Policies / Govt |
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US National Guidelines Clearinghouse on Episcleritis
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Books |
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News |
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Commentary |
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Definitions |
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Patient Resources / Community |
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Patient resources on Episcleritis Discussion groups on Episcleritis Patient Handouts on Episcleritis Directions to Hospitals Treating Episcleritis Risk calculators and risk factors for Episcleritis
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Healthcare Provider Resources |
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Causes & Risk Factors for Episcleritis |
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Continuing Medical Education (CME) |
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International |
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Business |
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Experimental / Informatics |
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 | |
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| Episcleritis |
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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
If left untreated, [#]% of patients with [disease name] may progress to develop [manifestation 1], [manifestation 2], and [manifestation 3].
OR
Common complications of [disease name] include [complication 1], [complication 2], and [complication 3].
OR
Prognosis is generally excellent/good/poor, and the 1/5/10-year mortality/survival rate of patients with [disease name] is approximately [#]%.
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.