Episcleritis can be observed in both eyes (bilateral) and like most diseases processes can vary from mild to severe. Episcleritis can be difficult to control with medication and tends to require medication to some degree on a long term basis. In the most difficult cases, systemic (oral immunosuppressant drugs) may be indicated
In most cases episcleritis is treated with topical anti-inflammatories. The severity and aggressiveness of the episclritis dictates the dosage and frequency of the topical medication. In severe cases, oral immunosuppressant drugs may be indicated. Episcleritis is not treated surgically.