Granulomatous Episcleritis
Nodular granulomatous episcleritis (NGE) is an immune-mediated inflammatory and proliferative disorder of the sclera and episclera. It is also referred to as pseudotumor, fibrous histiocytoma, limbal granuloma, and proliferative keratoconjunctivitis. Clinically, one or, more commonly, several smooth, elevated, immobile red nodules are visible. These nodules result from granulomatous inflammation, originate at the limbus, and infiltrate the surrounding stroma. Thickening of the third eyelid is common. Patients experience discomfort, squinting, and tearing. A breed predisposition exists, with Collies and Shetland Sheepdogs most commonly affected.
Treatment
Diagnosis is based on the clinical appearance and histopathologic findings. Treatment consists of immunosuppressive medications. Corticosteroids may also be administered intralesionally or subconjunctivally. Surgical removal of lesions and cryotherapy are additional options.
Granulomatous episcleritis. A pink mass is visible in the temporal portion of the eye, together with edema and corneal vascularization adjacent to the mass.
Granulomatous episcleritis. Prominent scleral blood vessels are visible in this dog.
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Corneal Disease
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Adapted from the Atlas of Ocular Diseases in Dogs and Cats by Dr. Siniša D. Grozdanić and colleagues. © Animal Eye Consultants of Iowa. The text and clinical images on this page are original content from the authors' own clinical practice and research, and may not be reproduced, distributed, or repurposed without permission.
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