Scleritis and Episcleritis
Brit. J. Ophthal. (I976) 6o, I 63 Br J Ophthalmol: first published as 10.1136/bjo.60.3.163 on 1 March 1976. Downloaded from Scleritis and episcleritis PETER G. WATSON* AND SOHAN SINGH HAYREHt From Moorfields Eye Hospital, City Road, London*, and Addenbrooke's Hospital, Cambridge*, and the Department of Ophthalmology, University of Iowa Hospitals and Clinics, Iowa City, USAt From the earliest available descriptions of episcleritis Leigh, I965), subconjunctival phlegma or simple (Slade, 1838; Rognetta, i844; Desmarres, 1847) or phlegmatous conjunctivitis by Mackenzie (I830), a confusion has existed between scleritis and and episcleritis periodica fugax by Fuchs (I895). episcleritis. This has led to contradictory views Duke-Elder and Leigh (I965) distinguished be- on the relative severity and prognosis of these tween nodular episcleritis and rheumatic episcleritis, conditions, and the erroneous belief that episcleritis but such a differentiation appears to be unjustified is accompanied by serious complications (Viswaling- as rheumatoid arthritis can be associated with ham, 1936; Wood, 1936; Mann and Markson, I950; either condition. We have classified episcleritis Clavel and Teulieres, 1958). While Slade (I838), into two types: Rognetta (i844), and Desmarres (I847), thought i. Simple episcleritis that episcleritis was both common and severe, 2. Nodular episcleritis. Mackenzie (i830) considered it to be neither and gave copyright. at the same time a vivid and accurate description SCLERITIS of scleritis. This confusion still persists today. In an attempt to clarify the position we have Many classifications of scleral disease have been been studying patients with scleritis and episcleritis proposed (Holthouse, I893; van der Hoeve, in a special clinic at Moorfields Eye Hospital 1934; Franceschetti and Bischler, I950; Duke- during the past io years.
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