Red eye (by symptoms)

Background

Eye anatomy.

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

Caustic Contamination

• Caustic Keratoconjunctivitis**

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
• Foreign Body
• 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

Purulent Discharge

• bacterial Conjunctivitis*

Itching

• Allergic Conjunctivitis

Topical Meds or Cosmetics

• Chemical (Contact) Conjunctivitis

None of the Above

• Chlamydia Conjunctivitis
• Viral Conjunctivitis

See Also

Eye Algorithms

• Red eye
  • Bilateral red eyes
  • Unilateral red eye
  • Red eye (by symptoms)
  • Red eye (peds)
    • Neonatal conjunctivitis
• Periorbital swelling
• Acute vision loss (noninflamed)
• Acute onset flashers and floaters
• Painful eyes with normal exam
• Neonatal eye problems