Episcleritis

An eye disease is not the first complication you may think of when it comes to Inflammatory bowel disease (IBD), but many people with IBD experience complications outside of the digestive tract. In fact, there are several eye conditions that are more common in people who also have IBD. Episcleritis is an uncommon eye condition associated with IBD that will typically resolve on its own and does not lead to loss of vision.

What Is Episcleritis?

Episcleritis is inflammation in the episclera of the eye. The episclera is the tissue that lies over the sclera (the white of the eye). Symptoms typically begin abruptly and may be in one or both eyes.

Symptoms of Episcleritis

Symptoms of episcleritis can include:

• Red or pink in the white of the eye
• Irritation
• Nodules on the episclera
• Pain (not typical)
• Waterting

Causes of Episcleritis

In most cases, the cause of episcleritis is unknown. In some cases, episcleritis could be the result of an immune response. It is also associated with several diseases and infections such as:

• Rheumatoid arthritis
• Sjogren syndrome
• Syphilis
• Tuberculosis

Who Gets Episcleritis?

Most cases (about 70 percent) of episcleritis occur in women, and the condition is more common in young and middle-aged people. Anywhere from 2 to 5 percent of people with IBD will develop episcleritis. Typically the episcleritis will resolve when the underlying IBD is under control.

Treatment for Episcleritis

In most cases, episcleritis is a self limiting condition and will resolve on its own without any treatment. Treatment is often given to help lessen discomfort from symptoms. Artificial tears may be helpful, and they can be used until the episcleritis resolves. For those who are experiencing more pain or discomfort, eye drops containing a non-steroidal anti-inflammatory (NSAID) may be used for a few weeks. If topical measures do not provide any relief, an oral NSAID may be prescribed to help with symptoms. In cases where there are nodules, an oral steroid might be used, but this is very rare.

For episcleritis associated with autoimmune conditions such as IBD, treatment is with a topical steroid. Topical steroids increase the risk for other eye conditions such as infection, cataracts and glaucoma so their use should be as brief as possible. Treating the underlying autoimmune condition is also recommended.

_Sources:

_{Petrelli EA, McKinley M, Troncale FJ. "Ocular manifestations of inflammatory bowel disease." Ann Ophthalmol Apr 1982; 14:356-360. 15 Jul 2010.}

_{Stone JH, Dana MR. "Episcleritis." UpToDate 6 Jan 2010. 15 Jul 2010.}

_{Vorvick L, Zieve D. "Episcleritis." A.D.A.M. 15 Jul 2008. 15 Jul 2010.}