Vision usually preserved, pupils reactive to light, conjunctival injections, no corneal involvement, preauricular lymph node swelling is sometimes present ![]() Severe pain copious, purulent discharge diminished vision ![]() Other pathogens: Staphylococcus species, Moraxella species, Neisseria gonorrhoeae, gram-negative organisms (e.g., Escherichia coli), Pseudomonas speciesĬhemosis with possible corneal involvement Mild to moderate pain with stinging sensation, red eye with foreign body sensation, mild to moderate purulent discharge, mucopurulent secretions with bilateral glued eyes upon awakening (best predictor)Ĭommon pathogens in children: Streptococcus pneumoniae, nontypeable Haemophilus influenzaeĬommon pathogen in adults: Staphylococcus aureus Pain and tingling sensation precedes rash and conjunctivitis, typically unilateral with dermatomal involvement (periocular vesicles)Įyelid edema, preserved visual acuity, conjunctival injection, normal pupil reaction, no corneal involvement Mild to no pain, diffuse hyperemia, occasional gritty discomfort with mild itching, watery to serous discharge, photophobia (uncommon), often unilateral at onset with second eye involved within one or two days, severe cases may cause subepithelial corneal opacities and pseudomembranesĪdenovirus (most common), enterovirus, coxsackievirus, VZV, Epstein-Barr virus, HSV, influenza Normal vision, normal pupil size and reaction to light, diffuse conjunctival injections (redness), preauricular lymphadenopathy, lymphoid follicle on the undersurface of the eyelid Referral is necessary when severe pain is not relieved with topical anesthetics topical steroids are needed or the patient has vision loss, copious purulent discharge, corneal involvement, traumatic eye injury, recent ocular surgery, distorted pupil, herpes infection, or recurrent infections. Recognizing the need for emergent referral to an ophthalmologist is key in the primary care management of red eye. The cause of red eye can be diagnosed through a detailed patient history and careful eye examination, and treatment is based on the underlying etiology. Allergies or irritants also may cause conjunctivitis. Because there is no specific diagnostic test to differentiate viral from bacterial conjunctivitis, most cases are treated using broad-spectrum antibiotics. Generally, viral and bacterial conjunctivitis are self-limiting conditions, and serious complications are rare. ![]() Signs and symptoms of red eye include eye discharge, redness, pain, photophobia, itching, and visual changes. Other common causes include blepharitis, corneal abrasion, foreign body, subconjunctival hemorrhage, keratitis, iritis, glaucoma, chemical burn, and scleritis. Conjunctivitis is the most common cause of red eye. The condition is usually benign and can be managed by primary care physicians. Red eye is the cardinal sign of ocular inflammation.
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