Red eye (by symptoms): Difference between revisions

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==CAUSTIC CONTAMINATION==
==Background==
-caustic keratoconjunctivitis**
[[File:Schematic diagram of the human eye en.png|thumb|Eye anatomy.]]
*This page describes a general approach to the complaint of eye redness by symptoms


[anesth/irrigation until ph 7/optho]
==Caustic Contamination==
*[[Caustic Keratoconjunctivitis]]**


...alkaline exp requires min 4L over 40min
==Proptosis or Swelling==
*[[Blepharitis]]
*[[Chalazion]]
*[[Stye (Hordeolum)]]
*[[Dacryocystitis]]
*inflammatory pseudotumor: retrobulbar inflammation
**(check intraocular pressure, work up for systemic disease, CT orbits, steroids and optho consult)
*[[Periorbital Cellulitis]]*
*[[Orbital Cellulitis]]
*[[Retrobulbar hematoma]]/abscess/emphysema
*orbital tumor*
**(check intraocular pressure, CT orbits, optho consult)


==PROPTOSIS or EXT SWELLING==
==Unilateral Red/Painful==
-blepharitis
*[[Corneal Abrasion and Foreign Body]]
*[[Corneal Ulcer]]
*[[ocular foreign body|Foreign Body]]
*[[blunt eye trauma|Trauma]]
*[[Endophthalmitis]] following prior surgery, with [[hypopyon]] or pus in anterior chamber


[warm compresses 15min 4x/day, scrub w/ mild shampoo BID, outpt optho]
====Less Common====
*[[Periorbital cellulitis]]/[[orbital cellulitis]]
*Acute [[Glaucoma]]: corneal clouding
*[[Scleritis]]
*[[Uveitis]] (recurrent in AS): keratic precipitates
**photophobia, perilimbal injection
*[[Hyphema]]/[[Hypopyon]]
*[[Herpes Zoster Ophthalmicus]] (look for concurrent skin findings)
*[[Thyroid]] disease


-chalazion
==Severe Pain or FB Sensation==
*keratitis*
**[rule out penetration, tetanus, topical antibiotics, optho referral]
*[[Keratoconjunctivitis]]
*[[Episcleritis]]
*[[Scleritis]]
*Anterior [[Uveitis]]*
*[[Acute Angle-Closure Glaucoma]]
*[[Traumatic Hyphema]]
*[[Endophthalmitis]]*


-stye (hordeolum)
==Focal Redness or Bulbar Conjunctiva==
*inflamed [[Pterygium]]
*scleral penetration**
**[pain relief, antiemetic, tetanus, admit optho]
*[[Subconjunctival Hematoma]]


[warm compress 15min 4xday, massage, optho if fails]
==Purulent Discharge==
*bacterial [[Conjunctivitis]]*


==Itching==
*Allergic [[Conjunctivitis]]


-dacrocystitis:inflammation lower eyelid near punctum
==Topical Meds or Cosmetics==
*Chemical (Contact) [[Conjunctivitis]]


[oral analgesia, abx, optho]
==None of the Above==
*Chlamydia [[Conjunctivitis]]
*Viral [[Conjunctivitis]]


==See Also==
{{Eye algorithms}}


-inflam pseudotumor: retrobulbar inflamm
==References==
 
<references/>
[iop, systemic w/u, CT, steroids and optho]
[[Category:Ophthalmology]]
 
[[Category:Symptoms]]
 
-peri/orbital cellulitis*: orbital w/ systemic sx
 
[CTX/Vanco, cx, CT, admit]
 
-retrobulbar abscess/emphysema/hematoma**
 
[iop, abx, correct coagulopathy, admit]
 
 
-orbital tumor*
 
[iop, ct, optho]
 
==SEVERE PAIN or FB SENSATION==
-keratitis*
 
[r/o penetration, tetanus, topical abx, optho referral]
 
 
 
-keratoconjunctivitis
 
-epi/scleritis
 
-anterior uveitis*
 
[optho recs]
 
 
-acute angle-closure glaucoma**
 
[iop, timolol, apraclonidine, prednisolone, pilocarpine, mannitol 2g/kg IV]
 
 
-hyphema*
 
[r/o rupture, head elevation, optho]
 
-endophthalmitis*
 
[CTX, vanco; admit to optho]
 
==FOCAL REDNESS or BULBAR CONJUNCTIVA==
-inflamed pterygium
 
[naphazoline/ketorolac drops, outpt referral]
 
 
-scleral penetration**
 
[pain relief, antiemetic, tetanus, admit optho]
 
 
-subconjunctival hemorrhage
 
[hx re coagulopathy, reassure will resolve 2-3 wks]
 
==PURULENT DISCHARGE==
 
-bacterial conjunctivitis*
 
[peds: polymyxin B + trimethoprim ointment 10Ds OU]
 
[adults: sulfacetamide or gent; cipro if pseudomonas; drops 10D OU]
 
==ITCHING SENSATION==
 
-allergic conjunctivitis
 
[naphazoline drops, oral antihistamines, outpt optho]
 
==TOPICAL MEDS or COSMETICS==
 
-contact dermatoconjunctivitis
 
-toxic conjunctivitis
 
[irrigate, naphazoline drops, outpt for tx failure]
 
==IF NONE OF ABOVE: (consider)==
 
-Chlamydia conjunctivitis
 
[PO erythromycin x 14D; CTX for gonorrhea]
 
-viral conjunctivitis
 
[naphazoline or ketorolac drops]
 
 
==Source==
Adapted from Pani
 
[[Category:Ophtho]]

Latest revision as of 18:12, 4 February 2026

Background

Eye anatomy.
  • This page describes a general approach to the complaint of eye redness by symptoms

Caustic Contamination

Proptosis or Swelling

Unilateral Red/Painful

Less Common

Severe Pain or FB Sensation

Focal Redness or Bulbar Conjunctiva

Purulent Discharge

Itching

Topical Meds or Cosmetics

None of the Above

See Also

Eye Algorithms

References

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