Red Eye (by Sx)

Caustic Contamination

• Caustic Keratoconjunctivitis**

Proptosis or Swelling

• Blepharitis
• Chalazion
• Stye (Hordeolum)
• Dacrocystitis
• 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 Algorithm (Main)
• Red Eye (Unilateral)

References

Authors

Ross Donaldson, Claire, Neil Young, Jordan Swartz, Daniel Ostermayer, Jonathan Osgood