Nodular Granulomatous Episcleritis
Disease Description and Clinical Picture
Nodular granulomatous episcleritis (NGE) is an inflammatory condition of the sclera and episclera that is of immunological nature (also referred to as pseudotumor, fibrous histiocytoma, limbal granuloma, and proliferative keratoconjunctivitis). Clinically, single or several raised, immobile, red nodules are observed. These are the result of granulomatous inflammation and start from the limbus, infiltrating the surrounding corneal stroma and sclera. Patients can show signs of ocular discomfort, frequent blinking, and tearing, but in some cases, the condition can be without any evident symptoms of ocular discomfort. 
 
Therapy
The diagnosis is made based on the clinical picture and histopathological findings. Therapy is pursued with topical immunosuppressive drugs, and injectable corticosteroids may also be given subconjunctivally in close proximity to the affected region. In some cases, systemic immunosuppressive medications are needed to establish the control of the condition. There is the possibility of treating the affected area with cryotherapy (freezing of the affected tissue) in cases where medical treatment does not give adequate results.
 
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