What are the key features of episcleritis?

• A. Itching and tearing only
• B. Redness, usually painless or mild discomfort, typically no vision changes
• C. Purulent discharge
• D. Severe eye pain

Answer: (B)

Episcleritis presents as a red eye with little or no discomfort and preserved vision. The redness comes from inflamed superficial episcleral vessels, and patients typically have only mild irritation or none at all, with normal visual acuity and no corneal involvement. There is usually no purulent discharge and no significant eye pain, which helps distinguish it from infections or more serious inflammatory conditions. In contrast, conditions that cause purulent discharge, severe eye pain, or noticeable vision changes point away from episcleritis toward conjunctival infection, keratitis, or scleritis, which require different management. The combination of redness with minimal or no pain and unchanged vision is the hallmark feature of episcleritis.