Red Eye

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Red Eye


A red eye can be alarming but is often just a sign of a minor eye condition, such as conjunctivitis or a burst blood vessel. If it is painful, there may be a more serious problem.

Ocular pain is often associated with a red eye.

red-eyes



Diagnosis
History
Examination
1
Subconjunctival haemorrhage
Typically asymptomatic, spontaneous. May be associated with trauma
Unilateral (except some trauma) contiguous red area
2
Viral conjunctivitis
Foreign body sensation, watering, no visual loss or photophobia, ?Recent contact with person with red eye or URTI
Bilateral, prominent inflamed conjunctival vessels, follicles, enlarged tender preauricular lymph node
3
Bacterial conjunctivitis
Foreign body sensation, discharge, no visual loss or photophobia
Bilateral, prominent inflamed conjunctival vessels, mucopus
4
Allergic conjunctivitis
Itch, watering, no visual loss or photophobia, history of atopy
Bilateral, prominent inflamed conjunctival vessels, follicles
5
Iritis (anterior uveitis)
Reduced vision, aching sensation, photophobia, PMH or systemic enquiry may elicit underlying disease
Unilateral, prominent pericorneal vessels, small pupil, aqueous cells and protein (at slit lamp), hypopyon
6
Acute angle-closure glaucoma
Severe pain, haloes/rainbows around lights, redused vision, hypermetropic, elderly
Unilateral, pericorneal prominent vessels, semidilated (oval) pupil, corneal oedema, shallow anterior chamber (slit lamp)
7
Episcleritis
Mild discomfort, tenderness, no visual loss or photophobia, young adult, otherwise fit and well
Unilateral, typically sectorial prominent inflamed subconjunctival vessels (may also be nodular or diffuse)
8
Scleritis
Significant aching pain, tender, photophobia, occasionally reduced vision, systemic enquiry may elicit underlying disease
Unilateral, typically sectorial prominent inflamed deep scleral vessels (may also be nodular or diffuse)
9
Becterial keratitis
Foreign body sensation, watering/discharge, visual loss, photophobia, ? Pre-existing ocular surface disease, recent trauma or contact lens wear
Unilateral, opacity in cornea (slit lamp) stains with fluorescein
10
Herpetic viral keratitis
Foreign body sensation, watering/dischange, visual loss, photophobia, ?Cold scores or ophthalmic shingles
Unilateral, branching linear dendrite(s) on cornea (slit lamp) stains with fluorescein



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