title: [Diagnosis and treatment of episcleritis and scleritis].
abstract: Episcleritis is a benign and self-limiting disease, often with a recurrent course, manifesting mainly in young adults. In less than a third of patients, an associated systemic disease can be found. In contrast, scleritis is observed mainly in patients between the 4th and 6th decade of life, may lead to severe ocular complications, and is often associated with a systemic rheumatological disease. Diffuse, nodular, and necrotizing forms of scleritis can be differentiated. Necrotizing and posterior scleritis have a higher risk of complications and worse visual outcome. In most cases, medical history and slit lamp examination allow differentiation of episcleritis and scleritis. Whereas episcleritis is treated mainly symptomatically with artificial tears, topical corticosteroids, and potentially with systemic nonsteroidal anti-inflammatory drugs, scleritis requires early and aggressive anti-inflammatory treatment in a stepwise approach.
authors.affiliation: Universitätsklinik für Augenheilkunde, Inselspital, Universität Bern, 3010, Bern, Schweiz. christoph.tappeiner@insel.ch.|Augenabteilung am St. Franziskus Hospital, Münster, Deutschland. christoph.tappeiner@insel.ch.
authors.forename: C
authors.initials: C
authors.lastname: Tappeiner
authors.affiliation: Augenabteilung am St. Franziskus Hospital, Münster, Deutschland.
authors.forename: K
authors.initials: K
authors.lastname: Walscheid
authors.affiliation: Augenabteilung am St. Franziskus Hospital, Münster, Deutschland.|Universität Duisburg-Essen, Essen, Deutschland.
authors.forename: A
authors.initials: A
authors.lastname: Heiligenhaus
mesh_terms: D000305:Adrenal Cortex Hormones / Q000008:administration & dosage*; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage*; D003937:Diagnosis, Differential; D019317:Evidence-Based Medicine; D006801:Humans; D008487:Medical History Taking / Q000379:methods; D009883:Ophthalmic Solutions / Q000008:administration & dosage*; D015423:Scleritis / Q000175:diagnosis* / Q000188:drug therapy*; D000072776:Slit Lamp Microscopy / Q000379:methods*; D016896:Treatment Outcome
chemical_list: D000305:Adrenal Cortex Hormones; D000893:Anti-Inflammatory Agents; D009883:Ophthalmic Solutions
keywords: Complications; Diagnosis; Prognosis; Systemic disease; Treatment