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The Red Eye (non-traumatic cases)

 

About 80 % of the patients referred to our casualty present with a red eye. A careful clinical 
assessment usually produced a correct diagnosis. 

The causes of the red eye can be divided roughly into two groups: 

    • pain with or without  blurring of vision
    • no pain and normal vision
The examination of the patients should include : 
 
History:
  • Use of contact lens

    • (consider corneal ulcer in contact
    lens users with painful eye)
     
  • Sticky discharge (suggest

    • infective conjunctivitis)
     
  • Past history of iritis 

    • (consider recurrence)
     
  • Presence of itching

    • (allergic conjunctivitis)
 		 Examination:
  • Assessment of both eyes with Snellen chart (reduced vision needs urgent referrals)

    •  
  • Examine the anterior segment with a bright torch and note:

    •  
    • injection of the conjunctiva

      • (conjunctivitis)
       
    • cornea for opacity 

      • (ulcer or acute glaucoma)
       
    • pupil reaction to light 

      • (fixed pupil is seen in 
      acute glaucoma and iritis)

Patients with pain +/- blurring of vision is likely to have a sight-threatening conditions. 
The most important differential diagnosis are: 


Patient without pain are likely to have a self-limiting conditions, the most common are: