Red eye resident survival guide: Difference between revisions
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Revision as of 18:11, 29 July 2020
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Seyed Arash Javadmoosavi, MD[2]
Overview
Red eye is an essential sign of eye inflammation. Although it is usually benign and can be managed by primary care physician, It is important to distinguish between benign and sight-threatening diagnoses. Its most common cause is conjunctivitis. However, the other common causes are subconjunctival hemorrhage, blepharitis, scleritis, corneal abrasion, glaucoma and foreign body. Red eye can be concomitant photophobia, eye discharge, pain, itiching and visual changes.
Causes
Life Threatening Causes
Life-threatening causes include conditions which may result in death or permanent disability within 24 hours if left untreated.[1]
- Acute angle closure glaucoma (AACG)
- Endophthalmitis
- Bacterial keratitis
- Chemical burn
- Traumatic eye injury
- Scleritis
- Corneal ulcer
- Hyper acute conjunctivitis
Common Causes
Diagnosis
Shown below is an algorithm summarizing the diagnosis of red eye.[3][2]
{{Patients with red eye | |||||||||||||||||||||||||||||||||||||||||
Mild or no pain with mild blurring or normal vision | Moderate to severe pain | ||||||||||||||||||||||||||||||||||||||||
| Local | Diffuse | ||||||||||||||||||||||||||||||||||||||||
| Discharge | Emergency Ophthalmology referral | ||||||||||||||||||||||||||||||||||||||||
| No | Yes | ||||||||||||||||||||||||||||||||||||||||
| Intermittent | Continuous | ||||||||||||||||||||||||||||||||||||||||
| Dry eye | Watery or Serous | Mucopurulent to Purulent | |||||||||||||||||||||||||||||||||||||||
| Itiching | Clamydial Conjunctivitis | Acute bacterial conjunctivitis | |||||||||||||||||||||||||||||||||||||||
| Mild to non | Moderate to severe | ||||||||||||||||||||||||||||||||||||||||
| Viral Conjunctivitis | Allergic Conjunctivitis | ||||||||||||||||||||||||||||||||||||||||
Treatment
The management of the red eye will depend on the underlying cause.
- Life-threatening causes
| AACG | Endophthalmitis | Necrotizing Scleritis | Herpetic keratitis | Chemical injury |
|---|---|---|---|---|
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Do's
- Using artificial tears in patients with dry eye.
- Protection against UV rays.
Don'ts
- Avoid wearing contact lenses.
- Avoid using sharp equipment specially in children.
References
- ↑ Gilani CJ, Yang A, Yonkers M, Boysen-Osborn M (2017). "Differentiating Urgent and Emergent Causes of Acute Red Eye for the Emergency Physician". West J Emerg Med. 18 (3): 509–517. doi:10.5811/westjem.2016.12.31798. PMC 5391903. PMID 28435504.
- ↑ 2.0 2.1 Cronau H, Kankanala RR, Mauger T (2010). "Diagnosis and management of red eye in primary care". Am Fam Physician. 81 (2): 137–44. PMID 20082509.
- ↑ Noble J, Lloyd JC (2011). "The red eye". CMAJ. 183 (1): 81. doi:10.1503/cmaj.090379. PMC 3017259. PMID 20921253.
- ↑ Murray D (2018). "Emergency management: angle-closure glaucoma". Community Eye Health. 31 (103): 64. PMC 6253313. PMID 30487684.
- ↑ Novosad BD, Callegan MC (2010). "Severe bacterial endophthalmitis: towards improving clinical outcomes". Expert Rev Ophthalmol. 5 (5): 689–698. doi:10.1586/eop.10.52. PMC 3092298. PMID 21572565.
- ↑ Lawuyi LE, Gurbaxani A (2016). "Refractory necrotizing scleritis successfully treated with adalimumab". J Ophthalmic Inflamm Infect. 6 (1): 37. doi:10.1186/s12348-016-0107-y. PMC 5059540. PMID 27734292.
- ↑ Singh P, Tyagi M, Kumar Y, Gupta KK, Sharma PD (2013). "Ocular chemical injuries and their management". Oman J Ophthalmol. 6 (2): 83–6. doi:10.4103/0974-620X.116624. PMC 3779420. PMID 24082664.