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Ask Dr. Dan B. Your Own Question
Dr. Dan B.
Dr. Dan B., Board Certified Ophthalmologist
Category: Eye
Satisfied Customers: 3343
Experience:  Eye surgeon experienced in cataracts, glaucoma, retina & neuro-ophthalmology
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What causes episcleritis How long should symptoms be tolertaed. Six

Customer Question

What causes episcleritis? How long should symptoms be tolertaed.
Six weeks ago i developed a hordeolem on my lower lid. The MD expressed the hordeolem and then the scleritis eventually formed. I was first treating the hordeolem with Tobedex. The MD said it wouldnt touch the hordeolem beacuse it was not an opened wound. So i did the hot compresses (after he expressed). Then the redness of the sclerea started. He said the hordeolem now probably wasn't "letting go" due to episcleritis developing. My OD then put me on Lotemax 3xday. I did this for six days and demanded an antibiotic. So yeaterday i was given Vigamox 3xday in addition to the Lotemax.
PLEASE???!!!!!!!!!!! Am i going to be ok and do you agree with the treatment.
I simply want to know. This has been being fought for SIX WEEKS altogether.
I am not on a witch hunt. I just want to get well and know i am ok???
Submitted: 6 years ago.
Category: Eye
Expert:  Dr. Dan B. replied 6 years ago.

A hordeolum usually does not respond solely to an antibiotic or steroid; the best treatment for them is intensive hot compresses (4x/day, 10 mins each time, as hot as you can tolerate without burning yourself, massaging the bump while it's on there). Sometimes it may take up to 3 weeks of doing this daily before it will go away. If it doesn't then it may need to be opened up. A combination steroid/antibiotic may be needed for it if the inflammation is significant or if a secondary skin infection develops with it, but this is the exception, not the rule.


As far as episcleritis is concerned, about half of the time it is the result of some systemic auto-immune disorder such as psoriasis, inflammatory bowel disease, arthritis, etc. The other half the time we don't know what causes it. Episcleritis usually goes away on its own, but sometimes a mild steroid is useful in taking care of it. Scleritis is a deeper inflammation that needs an oral nsaid to take care of it, so the diagnoses are distinct.


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My opinion is solely informative and does not constitute a formal medical opinion or recommendation. For a formal medical opinion and/or recommendation you must see an eye doctor.