Red eye (by symptoms): Difference between revisions

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==Background==
[[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
==Caustic Contamination==
==Caustic Contamination==
#caustic keratoconjunctivitis**===
*[[Caustic Keratoconjunctivitis]]**
##[anesth/irrigation until ph 7/optho]
 
##...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)
 
==Unilateral Red/Painful==
*[[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
 
====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
 
==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]]*
 
==Focal Redness or Bulbar Conjunctiva==
*inflamed [[Pterygium]]
*scleral penetration**
**[pain relief, antiemetic, tetanus, admit optho]
*[[Subconjunctival Hematoma]]


==PROPTOSIS or EXT SWELLING==
==Purulent Discharge==
#blepharitis
*bacterial [[Conjunctivitis]]*
##[warm compresses 15min 4x/day, scrub w/ mild shampoo BID, outpt optho]
#chalazion
#stye (hordeolum)
##[warm compress 15min 4xday, massage, optho if fails]
#dacrocystitis:inflammation lower eyelid near punctum
##[oral analgesia, abx, optho]
#inflam pseudotumor: retrobulbar inflamm
##[iop, systemic w/u, CT, steroids and optho]
#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==
==Itching==
#allergic conjunctivitis
*Allergic [[Conjunctivitis]]
##[naphazoline drops, oral antihistamines, outpt optho]


==TOPICAL MEDS or COSMETICS==
==Topical Meds or Cosmetics==
#contact dermatoconjunctivitis
*Chemical (Contact) [[Conjunctivitis]]
#toxic conjunctivitis
##[irrigate, naphazoline drops, outpt for tx failure]


==IF NONE OF ABOVE: (consider)==
==None of the Above==
#Chlamydia conjunctivitis
*Chlamydia [[Conjunctivitis]]
##[PO erythromycin x 14D; CTX for gonorrhea]
*Viral [[Conjunctivitis]]
#viral conjunctivitis
##[naphazoline or ketorolac drops]


==Source==
==See Also==
Adapted from Pani
{{Eye algorithms}}


[[Category:Ophtho]]
==References==
<references/>
[[Category:Ophthalmology]]
[[Category:Symptoms]]

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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