57 Episcleritis


General clinical examination is unremarkable. On ophthalmic examination the most obvious abnormality is the red eye. Marked episcleral congestion will be present, together with some overlying conjunctival hyperaemia. Thus the superficial conjunctival vessels – the thin bright red branching ones – will be engorged, while the deeper, darker, straighter episcleral vessels will be thickened and more tortuous than usual. There will be some diffuse swelling in the area but this will not be excessive (not true chemosis) (Figure 57.1).

The episcleral congestion can be diffuse, affecting large quadrants of the globe, or can be a discrete nodular swelling. With the latter, the lesion is not usually firmly attached to the underlying sclera and can be moved slightly with a moistened cotton bud. However, if the nodule extends into the cornea it will be less mobile. Some peripheral corneal oedema will be present, giving a blue tinge to the cornea adjacent to the limbus. This will be denser and affect slightly more of the cornea where the episcleral involvement is more severe. Fluorescein testing is negative.

The eye will be visual (unless very advanced disease is present involving the posterior segment but this is unusual) with a normal menace response, pupillary light reflexes and no evidence of intraocular disease. Intraocular pressures will be normal. In most cases fundus examination is normal, but in very severe cases there might be evidence of active chorioretinitis (with fuzzy, grey retinal elevations and perivascular cuffing as a direct extension from the outer episcleral inflammation) and even optic neuritis in a few cases.

Sep 10, 2016 | Posted by in SMALL ANIMAL | Comments Off on Episcleritis

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