Red Eye Differential - REF: Outlines in Clinical Medicine on Physicians' Online 2001
1. Conjunctivitis:
Viral (common): bilateral, watery discharge, spread by contact,
self-limited
Bacterial (Less common): unilateral, purulent discharge, risk factors
Allergic: bilateral, itchy, watery discharge, swelling
Chemical/Irritative: history of insult
Sicca Syndrome
2. Trauma
3. Iritis, Scleritis or Episcleritis
4. Corneal Abrasion/Ulcer: pain, tearing, decreased vision,
fluorescein staning defect, Antibiotics eye drops Rx .
Risk factors: contact lens wear, trauma, eyelid abnormality,
etc.
5. Orbital cellulitis: decrease vision, possible afferent pupillary defect, swollen periorbital tissue, proptosis, pain, often associated with sinusitis, decreased EOM
6. Uveitis: Intraocular inflammatioin, decreased vision, cloudy anterior chamber witih cells, pain; etiology include autoimmune, trauma, post-surgery, idiopathic.
7. Subconjunctival Hemorrhage:
spontaneous, sometimes due to Valsalva, harmless,
self-limited, normal vision, no pain or discharge
8. Pterygium (degenerative condition):
due to chronic sun exposure, relatively normal vision,
no significant discharge; common in Hispanics.
9. Periocular Abscess with conjunctivitis
10. Acute Closed Angle Glaucoma: decreased visin, mid-dilated pupil with anisocoria, red conjuctiva & cloudy cornea, very high intraorbital pressure, palpably discernable, headache, eye pain, nausea, vomiting; immediate referral to ophthalmologist.
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