Episcleral injection is redness of the deeper episcleral vessels, often appearing as a sectoral patch rather than diffuse conjunctival redness. It can indicate episcleritis or more serious scleritis.
Episcleritis and Scleritis
Episcleritis usually causes mild discomfort and redness that may blanch with topical vasoconstrictors and often relates to idiopathic or benign inflammatory changes. Scleritis produces deeper violaceous redness, significant pain, and is frequently linked with systemic autoimmune disease.
- Sectoral redness near the limbus is typical, sometimes tender to touch
- Recurrent episodes suggest underlying systemic associations
- Scleritis pain may radiate to jaw or temple and disturb sleep
- Vision may be affected in severe scleritis or associated keratitis
Assessment and Treatment
Distinguishing episcleritis from scleritis requires slit‑lamp examination and history. Management ranges from lubricants and topical anti‑inflammatories to systemic immunosuppression.
- Systemic work‑up is recommended when scleritis is suspected
- Prompt treatment prevents scleral thinning and complications
- Patients with known autoimmune disease should report new eye redness
- Regular follow‑up monitors for recurrence or progression
