Red eye resident survival guide
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
Don'ts
References
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