A randomised, double-blind trial of topical ketorolac vs artificial tears for the treatment of episcleritis

Purpose To determine whether topical ketorolac ( Acular) is more effective than artificial tears in treating the signs and symptoms of idiopathic episcleritis. Methods In this prospective, randomised, double-blind study, 38 eyes of 37 patients presenting with idiopathic episcleritis were allocated to receive either topical ketorolac ( 0.5%) or artificial tears three times a day for 3 weeks. The severity of patients' signs ( episcleral injection and the number of clock hours affected) were recorded at weekly intervals. Patients' symptoms ( perceived redness and pain scores) were recorded using a daily diary. Results There was no significant difference in the ophthalmic signs between the two groups at each assessment, including intensity of episcleral injection and the number of clock hours affected. No significant difference was found in the time to halve the baseline redness intensity scores ( 4.4 vs 6.1 days, P = 0.2) or pain scores ( 3.6 vs 4.3 days, P = 0.55). Significantly more patients on ketorolac reported stinging at the first follow-up visit (P < 0.001). Conclusion Topical ketorolac is not significantly better than artificial tears in treating the signs or symptoms of idiopathic episcleritis.