In addition, a discussion of the most common differential diagnoses for the presentation of red eye and its treatment is provided. Red flag warnings for eye redness include pain not discomfort or irritation, decreased vision, profuse discharge, and corneal defect grossly visible. Differential diagnosis of the red eye in small animals. A differential guide to 5 eye complaints mdedge family. Primary care physicians typically see 410 patients per week who complain of ocular symptoms.
Although the exact incidence of diagnoses presenting as a red eye is not well defined, most are benign. The condition is usually benign and can be managed by primary care physicians. The differential diagnosis of red eye can be narrowed down rapidly with simple baseline tests and targeted questioning. Eye education for emergency clinicians 4 introduction normally the eye has a strong resistance.
Patients commonly present with an acute red eye to the emergency department ed. Red eye differential diagnosis masarykova univerzita. Red eye is a catch all term for the inflamed or injected external appearance of the eye, for which there are many causes. This slide program provides an approach to differential diagnosis of conditions that can cause a red eye, helping physicians understand which conditions causing a red eye require immediate treatment, which may wait a few days, and which do not require treatment. The red eye challenge litfl ophthalmology befuddler. The red eye hsv keratitis anterior uveitis subconjunctival haemorrhage corneal ulcer episcleritis scleritis acute angle closure glaucoma conjunctivitis red eye. Patients with corneal abrasion may present with severe pain, but can be treated by a primary care physician. Differential diagnosis of the red eye carol slight nurse practitioner ophthalmology. A systematic diagnostic approach to the patient with a red eye will help the physician reach a differential diagnosis that will include most of the causes of a red eye. Acute vision loss noninflamed acute onset flashers and floaters. Acute red eye is a common presenting complaint to primary care physicians. Conjunctivitis is the most common cause of red eye. Anamnesis systemic disease eye disease devolopment of difficulties character of diffuculties. Learn more about other symptoms and how to treat them.
Pdf on may 1, 2011, khathutshelo percy mashige and others published differential diagnosis of red eye find, read and cite all the. The erythema in a red eye is often caused by conjunctival inflammation but also may result from dilated scleral or episcleral vessels or inflammation of the deeper structures of the eye and surrounding tissues. A detailed history, baseline ophthalmological tests, and accompanying manifestations can narrow down the differential diagnosis. Understand the diagnostic approach to the acute red eye 2. Physicians frequently encounter patients who complain of a red eye. The differential diagnosis is so large that the caregiver must be comfortable with all diagnoses and must be able to distinguish between them. Assessment of red eye differential diagnosis of symptoms. It is important to differentiate whether the person presenting with red eye needs same day assessment by an ophthalmologist, or if they can be safely managed in primary care. The first page of the pdf of this article appears above.
Serious and potentially sightthreatening causes of red eye include. A detailed history of the presenting symptoms and previous ophthalmological and medical history can narrow the differential diagnosis and aid in the. Because conjunctivitis is caused by various etiologies, clinicians must derive a differential diagnosis. Red eye by symptoms red eye peds neonatal conjunctivitis. The red eye in children is a frequent complaint in general practice. Iritis injected around cornea small, fixed, irregular normal, kps turgid, deep normal. The differential diagnosis includes both benign and sightthreatening conditions.
Chemosis of the conjunctiva is a type of eye inflammation, which causes the eyelids to swell. Differential diagnosis of red eye american academy of. Request pdf on jul 1, 2010, glenda smith and others published differential diagnosis of red eye find, read and cite all the research you need on researchgate. Red eye and orbital trauma pediatrics lecturio duration. Conjunctivitis papillae follicles purulent discharge redness chemosis. Although most red eyes seen in the primary care setting are a result of. Differential diagnosis of conjunctivitis and the red eye. Conjunctiva pupil cornea anterior chamber iop subconjunctival haemorrhage. The differential diagnosis of red eye can be narrowed down rapidly with simple. The most important findings in a patient with a red eye are the presence of pain, photophobia or reduced visual acuity table. A video on the main differential diagnoses for a patient presenting with a red eye, fourth in those created for my teaching project. A detailed history of the presenting symptoms and previous ophthalmological and medical history can narrow the differential diagnosis and aid in the interpretation of key examination findings. Assessment of red eye differentials bmj best practice. Signs and symptoms of red eye include eye discharge, redness, pain.
Knowledge of the various causes of conjunctivitis is important for pediatric clinicians to determine if the child requires specific treatment and if referral to an ophthalmologist is warranted. Differential diagnosis of pediatric conjunctivitis red. Pdf differential diagnosis of red eye researchgate. Diagnosis and management of red eye in primary care american. Understand the principles of management of the acute red eye 3. Most of them have red eye as the major clinical finding. Selected differential diagnosis of red eye continued. Diagnosis and management of red eye in primary care. Click on the image or right click to open the source website in a new browser. Blepharitis, hordeolum, and chalazion are associated with a localized red, swol len, tender eyelid. There is a wide differential diagnosis for red eye. Red eye is the cardinal sign of ocular inflammation. Recognise cases of red eye that require prompt referral to an ophthalmologist suggested reading ophthalmology.
Red eye is the most common eye disorder seen in primary care. Cause and effect symptom cause itching allergy burning lid disorders, dry eye foreign body sensation foreign body, corneal abrasion localized lid tenderness hordeolum, chalazion evaluation. Youll also find an ataglance table listing the differential diagnosis for each presentation, and a mnemonic to guide you through the elements of a comprehensive eye exam. Painless red eye causes ophthalmology geeky medics. A small percentage of patients with red eye need urgent ophthalmological referral and treatment, although the vast majority can be treated by the primary care clinician. If you continue browsing the site, you agree to the use of cookies on this website. Patients with ocular emergencies should be referred to an ophthalmologist at once, as should all patients whose diagnosis is in doubt. This article describes a pediatric clinical case presentation of red eye. A detailed history of the presenting symptoms and previous ophthalmic and medical history can narrow the differential diagnosis and aid in the interpretation of key examination findings. The red eye international council of ophthalmology. Differential diagnosis of red eye slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising. Managing the red eye 3 a guide to presenting managing the red eye managing the red eye introduces the primary care physician to skills useful in evaluating the red eye and provides a practical clinical approach to diagnosis and treatment of many common red eye disorders. Evaluation of red eye differential diagnosis of symptoms.
With a simple basic anamnesis, the pediatrician can guide the origin of hyperemia. The diagnosis of the cause of red eye can be a challenge for the pediatrician because the differential diagnosis includes a. Small, fixed, irregular normal, kps turgid, deep normal acute glaucoma entire eye red fixed, dilated, oval hazy shallow high. Differentiating urgent and emergent causes of acute red eye for. These images are a random sampling from a bing search on the term acute red eye. A thorough history and clinical assessment should enable you to rule out concerning features and narrow the differential diagnosis. Concerning features of a red eye include pain and reduce visual acuity. Other common causes include blepharitis, corneal abrasion, foreign body, subconjunctival hemorrhage, keratitis, iritis, glaucoma, chemical burn, and scleritis.
Diagnosis and management of pediatric conjunctivitis. If youre stuck for a differential diagnosis, fall back on working through the anatomical components of the eye and running through a pathophysiological sieve. Red eye red eye is sign of pathology of anterior or posterior ocular segment, of orbit or of ocular adnexa. Misdiagnosis is a major medicolegal pitfall, in that the truly emergent conditions that may cause red eye have major visionthreatening sequelae. Eye education for emergency clinicians 20 conclusion remember beware of the red eye.
Practitioners recorded brief details of every patient seen and detailed information concerning signs and symptoms, differential diagnosis and treatment for all patients presenting with a red eye during 20 consecutive days in the period between may and september 2004. This article examines possible causes of conjunctivitis after the neonatal period in this population. I like jeff manns approach to red eye he breaks the causes down into 3 groups. Principal causes of unilateral acute red eye, in the absence of. Question 6 what is the treatment for jasons ocular condition and general condition. A symptom common to eye impairments is conjunctivitis, or red eye, a commonly seen manifestation in an ambulatory pediatric population. The diagnosis of the cause of red eye can be a challenge for the pediatrician because the differential diagnosis includes a wide range of diseases, some potentially serious vision and given that the childs eye visual function is developing. Essentials of anatomy and physiology, examinations of the visual system, the child with suspected eye disease, chronic loss of vision, acute painless visual disturbance, the acute red eye, abnormal looking eyes, chronic ocular unease and associated. Acute red eye differential diagnosis conjunctivitis keratitis uveitisiritis acute angle closure glaucoma scleritis episcleritis subconjunctival haemorrhage ocular trauma.
Red eye is a common presenting complaint in ambulatory practice. Conjunctivitis scratchy or gritty sensation hyperacute bacterial conjunctivitis. Additionally, the audience will learn how to recognize more. Differential diagnosis of acute red eye medico theory. Evaluation of red eye differentials bmj best practice. Signs and symptoms of red eye include eye discharge, redness, pain, photophobia, itching, and visual changes. Subconjunctival haemorrhage diffuse or localised area of blood under. Common causes of a painless red eye include subconjunctival haemorrhage, episcleritis, conjunctivitis and blepharitis.
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