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Dr. Rick
Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 10553
Experience:  Ophthalmology since 1994 with Retina sub-specialty interest
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what is diffuse episcleritis what I am reading does not match

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what is diffuse episcleritis? what I am reading does not match symptoms now. Concern it's now more to it. The other symptoms are: one pupil is larger than the other, swelling across nose, it started in one eye and is now in the other, side of face is puffy, itching, liquid draining from eye, redness on lids, sores on side of eyes, start 2 months ago in one eye, pass 2 weeks have move to other eye. taking IBprophen 400mg and artifical tear plyvinyl alcohol.
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Dr. Rick :

Hi. I'll be happy to help you wtih your question.

Dr. Rick :

how did you learn you have diffuse episcleritis?

Dr. Rick :

Hi. Are you still by your computer? If so, we can chat live.

Dr. Rick :

I guess you are not currently at your computer. I will try to address your question in our Q&A format.

Customer: replied 6 years ago.


This is for my dad - he has been to a doctor already who has told him about this diffuse episcleritis.

Diffuse episcleritis presents as acute redness and mild pain in one or both eyes. It typically presents in young adults who may have no significant past medical history. It can be localized in a conjunctival nodule or diffusely involve the globe.


Iritis (inflammation inside the eye) and conjunctivitis may also be present at the same time as episcleritis. What causes episcleritis? Most of the time it is idiopathic (we don't know why it happened), or it can be secondary to an infection such as herpes zoster (chicken pox reactivation) or other illness such as rosacea, thyroid disease or atopy.


Treatments include natural tears 4x/day for mild disease, and NSAID (ibuprofen 200-600mg TID) with or without mild topical steroids such as FML 0.1% qid for more serious presentations.


In your case, since it seems to be getting worse on the ibuprofen, and you have changes in your pupil I am concerned that you may have some anterior uveitis. If this is true, it is important that you be evaluated by your ophthalmologist so she can grade the amount of uveitis (swelling inside the eye) you may have. This can only be done with a slit lamp exam. Also, it is possible that the swelling of your nose and the puffiness could be from acne rosacea, which is known to be associated with scleritis. Once again, your ophthalmologist should be able to make this diagnosis in the office. One of the treatments for rosacea is doxycyclene 100 mg/day and/or metranidazole cream.


I agree with you that more then just diffuse episcleritis may be going on now in your case. I suggest you see your ophthalmologist for a re-evaluation.


I hope that this information was helpful for you. Please, allow me get credit for my time and effort in assisting you and press the ACCEPT button for this assist. I will be glad to answer additional questions until you are satisfied. Thank you very much.

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Customer: replied 6 years ago.

I've been told to my dad should be tested for glaucoma? He's 69 and he's diabetic. Do you think so

Glaucoma check would be a routine part of a complete eye exam by an ophthalmologist. Nothing you have told me so far makes me think he has glaucoma, although acute iritis may cause the pressure to rise in his eye. If he gets in to his ophthalmologist tomorrow I all these things will be checked. His diabetes, of course, makes things more difficult anytime he gets sick. The best thing he can do is keep his blood sugar in control.
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