management

Last reviewed 10/2020

Most cases are self-limiting. Artificial tears may be useful in mild irritation (1).

The treatment of choice is an oral non-steroidal anti-inflammatory drug (NSAID). If these are not appropriate a topical NSAID such as Ketorolac trometamol may be appropriate.

• a randomised, double-blind study (2) has reported that topical ketorolac is not significantly better than artificial tears in the management of idiopathic episcleritis.

If this treatment does not keep the eye comfortable, the patient should be seen in the local ophthalmology clinic within 2-3 days.

Topical steroids such as dexamethasone eye drops are successful, but risk the complications associated with the use of steroid eye drops.

Reference:

• (1) Sivaraj RR et al. Ocular manifestations of systemic lupus erythematosus. Rheumatology (Oxford). 2007;46(12):1757-62
• (2) Williams CP et al. A randomised, double-blind trial of topical ketorolac vs artificial tears for the treatment of episcleritis. Eye. 2005;19(7):739-42