Red Eyes: Diagnosis, History and Examination
What is Red Eyes?
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.
| SN | 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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