How are episcleritis and scleritis diagnosed
What workup is indicated for a patient presenting with episcleritis or scleritis?
A history, medication history, physical examination, chest x-ray, and routine laboratory exam (complete blood count [CBC], comprehensive metabolic panel, urinalysis [UA], erythrocyte sedimentation rate [ESR], and C-reactive protein [CRP]) evaluating for associated diseases is necessary. Routine testing for antineutrophil cytoplasmic antibody (ANCA) should be performed in all patients with scleritis, as positivity may be seen when other manifestations of ANCA-associated vasculitis are absent and positive results tend to indicate more aggressive disease. Further workup (e.g., antinuclear antibody [ANA], rheumatoid factor [RF], anticyclic citrullinated peptide, imaging, and microbiology studies) should be considered based upon clinical suspicion following a thorough history and exam.
