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Educational content only
This page is general patient education, not medical advice. It does not diagnose conditions, recommend specific treatments for you, or replace a conversation with your eye care provider. Always consult a qualified clinician before making decisions about your eye health.
Episcleritis is a mild, self-limiting redness. Scleritis is a deeper, painful inflammation that can damage the eye and often points to a systemic autoimmune disease.
What helps
Here's the plan — and why it works.
Episcleritis
Often self-limited
Most episcleritis resolves on its own in 1–3 weeks. Lubricating drops ease discomfort. Topical steroids speed resolution if symptoms are persistent.
Mild scleritis
Oral NSAIDs
Indomethacin or other NSAIDs reduce inflammation and pain. Often the first line for non-necrotizing anterior scleritis.
Severe scleritis
Oral steroids + immunomodulators
When NSAIDs aren't enough, oral prednisone and disease-modifying drugs (methotrexate, biologics) bring it under control. Often co-managed with rheumatology.
Workup
Looking for systemic disease
First episode of scleritis usually triggers blood tests for rheumatoid factor, ANCA, ANA, and inflammatory markers. Finding the underlying disease guides long-term treatment.
Same-week exam if
A red eye with deep, boring pain that wakes you at night, especially with sensitivity to light or vision changes — this is scleritis until proven otherwise and needs prompt care.
Common questions
Honest answers to common questions.
How do I know which one I have?+
Episcleritis is uncomfortable but not painful. Scleritis is genuinely painful — often described as boring, deep, radiating to the head. Your eye doctor distinguishes them on slit lamp exam.
Do I have autoimmune disease?+
About half of scleritis patients have a systemic autoimmune condition — sometimes diagnosed for the first time through this workup. Episcleritis is less often linked to systemic disease.
Will eye drops fix it?+
Episcleritis often responds to drops. Scleritis usually needs systemic (oral) treatment — drops alone don't penetrate deep enough.
Will it come back?+
Episcleritis sometimes recurs, usually mildly. Scleritis recurrence depends on the underlying cause — well-controlled systemic disease keeps the eye quieter.
Can it damage my eye?+
Severe necrotizing scleritis can thin the sclera and rarely lead to perforation. Most scleritis treated appropriately resolves without lasting damage.