Episcleritis: Causes, Symptoms, and Treatment
Written by Sumiran Racherla, MD. Medically reviewed by Harsha Moole, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor treats Episcleritis?
An ophthalmologist, an eye doctor who is also a medical doctor, usually diagnoses and treats episcleritis. A primary care provider can also examine the eye. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What is episcleritis?
Episcleritis is irritation and inflammation (swelling) of the episclera. The episclera is a thin layer of tissue that covers the sclera, the white part of the eye. Episcleritis is not an infection. It is a common condition. In most cases the problem is mild and vision is normal.
There are two forms. In simple episcleritis, the eye is red without an obvious lump. In nodular episcleritis, a raised area of swollen tissue forms on the eye. A simple attack tends to peak in about 12 hours and then slowly fade over the next 2 to 3 days. Nodular episcleritis lasts longer than simple episcleritis.
Symptoms
The redness is usually in one eye. It may cover the whole eye or only one area. Some people have no other symptoms. Others may have:
- A pink or purple color in the normally white part of the eye.
- Eye pain.
- Eye tenderness.
- Sensitivity to light.
- Tearing of the eye.
Episcleritis looks bright red or pink. Scleritis, a look-alike condition, has a violet color. Severe pain or discharge from the eye is not typical for episcleritis and may point to another problem.
Causes and who gets it
The cause of episcleritis is often unknown. Some people also have a related disease, such as rheumatoid arthritis, Crohn disease, ulcerative colitis, or lupus. Rheumatoid arthritis is the most common one.
Episcleritis often shows up in people 20 to 50 years old. Adult women are affected more often than adult men. It sometimes occurs along with dry eye syndrome and blepharitis, which is inflammation of the eyelids.
How doctors diagnose it
A health care provider or eye doctor will do an eye exam. Most of the time, no special tests are needed. Diagnosis is based mainly on your history and an exam of the outside of the eye. The doctor may use a slit lamp, a tool that lets the doctor see the eye up close.
Doctors also check for look-alike problems, such as conjunctivitis (pink eye) and scleritis. People with repeated attacks and no known related disease may need wider checks, including blood tests.
Treatment
Episcleritis often goes away on its own, and the main step is reassurance. If the eye is uncomfortable, cool compresses or cooled artificial tears (lubricating eye drops) may help.
Doctors may also suggest NSAIDs taken by mouth. These are anti-inflammatory pain medicines. They are the mainstay of treatment, which means the main medicine choice. Steroid eye drops may ease symptoms faster. However, steroids may raise the risk of the problem coming back. Steroid use may also be linked to cataracts and glaucoma, which are eye diseases. People who use steroid drops should be monitored.
If a related disease is involved, treating that disease can help control episcleritis. Treating dry eye and blepharitis is also likely to help. There are no surgical treatments for episcleritis.
When to see a doctor
Contact your provider if your symptoms last more than 2 weeks. Get checked again if your pain gets worse. See an eye doctor promptly for severe pain or discharge from the eye, because those are not typical for episcleritis. Call 911 or go to the emergency room for a sudden change in vision. Rarely, irritation and inflammation of the white part of the eye may develop. This is called scleritis.
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. Either kind of doctor can look at a red eye, decide whether you need an eye doctor, and help follow up on a related disease such as rheumatoid arthritis.
Common questions
Is episcleritis serious?
No, it is usually not serious. In most cases the problem is mild and vision is normal. It may come back in some people. Rarely, the white of the eye becomes inflamed, which is called scleritis.
How long does episcleritis last?
Episcleritis most often goes away on its own in 1 to 2 weeks. Treatment may make symptoms go away sooner. Cases linked to another disease can last longer and come back several times.
Is episcleritis an infection?
No, episcleritis is not an infection. It is irritation and inflammation of the episclera, the thin tissue covering the white of the eye.
Can episcleritis be prevented?
No, doctors know of no way to prevent episcleritis. Treating a related disease may help control attacks.
Sources
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
