Severity of episcleritis and systemic disease association
Section snippets
Materials and methods
Episcleritis was defined by the presence of edema of the episclera and associated congestion of superficial episcleral vessels, which disappeared after the use of 10% phenylephrine eyedrops, and was classified based on the anatomic types proposed by Watson and Hayreh.1
Medical records of 100 consecutive patients with episcleritis evaluated at the Ocular Immunology Service of the Massachusetts Eye and Ear Infirmary between 1988 and 1998 were reviewed. Only those patients with true scleritis were
Results
One hundred patients (132 eyes) constituted the study population (Table 1). The mean age of patients at presentation was 43 years (range, 18–76 years). The majority of patients (69%) were female. Eighty-one patients (114 eyes) had a mean follow-up of 16.5 months (range, 1–189 months), and 19 patients who were referred for a second opinion had only 1 visit. These patients were not included in the statistical analyses of longitudinal follow-up data.
Twenty (20%) of 100 patients had bilateral
Discussion
Episcleritis is usually a benign, self-limited inflammation. It has been reported to affect all age groups but most commonly middle-aged women.2 The mean age was 43 years (range, 18–76 years) in our series. Females predominated with a male/female ratio of 3/7.
The majority of episcleritis cases are idiopathic in nature. However, a significant number of patients with episcleritis, between 26% and 32%,1, 6 have an associated systemic disorder. In our series, 36 patients (36%) had a systemic
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2016, Survey of OphthalmologyCitation Excerpt :Rheumatoid arthritis has been reported in up to 11.1 % of patients with episcleritis.63 In one study, episcleritis patients with longstanding rheumatoid disease experienced more corneal complications such as sclerosis keratitis than patients with episcleritis in the absence of rheumatoid disease100; however, there was no correlation between the type of episcleritis, laterality, or recurrence of episcleritis and the presence of a systemic disease.6 A careful and detailed review of systems at the initial visit is therefore recommended in all patients.
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