Diffuse episcleritis - External and Internal Eye
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Synopsis
Diffuse episcleritis is a frequently recurring inflammatory condition of the episcleral tissue, which is often bilateral. Onset is usually acute. Symptoms may only be that of a reddened area of the surface of the eye or include pain, photophobia, tearing, and a hot prickly feeling with rare tenderness to manipulation. About one third of patients have an associated underlying systemic condition. Unlike the nodular form of the disease, most episodes of diffuse episcleritis are of short duration (10–21 days) and usually require little if any treatment. The incidence is higher in females and is more common in the fourth to fifth decades. Recurrences may be of either the diffuse type or the nodular type of episcleritis.
Codes
ICD10CM:
H15.109 – Unspecified episcleritis, unspecified eye
SNOMEDCT:
314549003 – Diffuse episcleritis
H15.109 – Unspecified episcleritis, unspecified eye
SNOMEDCT:
314549003 – Diffuse episcleritis
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Diagnostic Pearls
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Differential Diagnosis & Pitfalls
The most common differential diagnoses are those conditions producing a red eye, such as conjunctivitis (viral, allergic), keratoconjunctivitis, intraocular inflammatory disease, trauma, and scleritis. The latter is ruled out as noted in the Diagnostic Pearls section. Hyperuricemia (occurring in about 10% of cases) can be overlooked.
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Management Pearls
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Therapy
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Drug Reaction Data
Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.
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References
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Last Updated:01/24/2013
Diffuse episcleritis - External and Internal Eye