What is the recommended first-line treatment for uncomplicated episcleritis in adults?

Guideline-aligned answer with reasoning, red flags and references. Clinically reviewed by Dr Kola Tytler MBBS CertHE MBA MRCGP.

Posted: 17 August 2025Updated: 17 August 2025 Guideline-Aligned (High Confidence) Clinically Reviewed
Dr Kola Tytler MBBS CertHE MBA MRCGPClinical Lead • iatroX

First-line treatment for uncomplicated episcleritis in adults typically involves supportive care with lubricating eye drops (artificial tears) and oral non-steroidal anti-inflammatory drugs (NSAIDs) to relieve discomfort and inflammation.

Topical corticosteroids may be considered if symptoms are severe or persistent, but specialist referral is advised if symptoms do not improve or if there is diagnostic uncertainty to exclude other causes such as scleritis or uveitis.

Referral to ophthalmology is recommended if there is significant pain, vision changes, or if the diagnosis is unclear.

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