If episcleritis recurs, what may be pursued?

• A. Blood work to assess underlying cause
• B. Immediate surgery
• C. High-dose antibiotics
• D. No further testing

Answer: (A)

Recurring episcleritis can signal an underlying systemic inflammatory or autoimmune process, so pursuing a basic systemic workup with blood tests is appropriate. While episcleritis is often idiopathic, repeated episodes raise concern for conditions such as inflammatory arthritis, lupus, sarcoidosis, or other autoimmune diseases. A reasonable approach is to screen with blood tests that look for inflammation and autoimmunity—examples include inflammatory markers (ESR or CRP), a CBC, and autoimmune serologies (ANA, RF). Based on history and exam, additional targeted tests or specialist referrals may follow.

Immediate surgery is not indicated for episcleritis, as it is an inflammatory condition rather than a surgical problem. High-dose antibiotics are not appropriate since infection is not the typical cause. No further testing would miss potential systemic associations when episodes recur.