The differential diagnosis for red eye is broad because many ophthalmic conditions masquerade as conjunctivitis table. A differential guide to 5 eye complaints mdedge family. This small handbook was meant to provide a differential diagnosis for those who provide eye care. Assessing the painful, uninflamed eye in primary care the bmj. There are little epidemiologic data on the red eye, and there are no evidencebased data to guide us in the management of these patients. The differential diagnosis of red eye can be narrowed down rapidly with. Macleods clinical diagnosis demonstrates how to apply the core clinical skills learned from the companion textbook macleods clinical examination to maximum advantage. Mar 17, 2009 differential diagnosis of red eye slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising. Differential diagnosis of eye diseases jama ophthalmology. 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. Assessing the painful, uninflamed eye in primary care. In the emergency department, 75% of ophthalmologic complaints are due to conjunctivitis, corneal abrasions, or foreign bodies.
The differential diagnosis of a unilateral red eye is shown in. Around 25% of general practice patients have an eye complaint featuring pain in and around the eye ocular, periocular, and periorbital pain, described here collectively as eye pain. Neonatal conjunctivitis ophthalmia neonatorum differential. Potential causes of a red painful eye include scleritis, uveitis, corneal abrasion, corneal ulcer, viral keratitis, acute angle closure glaucoma, endophthalmitis foreign body and chemical injury. The presence of eye pain and reduced visual acuity are red flags for sinister ophthalmological diagnoses. The most common cause of red eye presenting in a primary care setting is conjunctivitis.
A small proportion of red eye cases are serious and need urgent treatment. Signs and symptoms of red eye include eye discharge, redness, pain. A red eye is a nonspecific term to describe an eye that appears red due to illness or. Dry eye disorders there is inadequate tear volume or function resulting in an unstable tear film and ocular surface disease. Red eye is the cardinal sign of ocular inflammation. A painful red eye answer 1 the differential diagnosis of a unilateral red eye is shown in table 1. Atopic dermatitis contact dermatitis rosacea eyelid disorders allergic reaction, locally hordeolum, stye chalazion blepharitis herpes simplex. The differential diagnosis of the red eye springerlink. The challenge lies in discerning one from the other. Pubmed database was used for articles selection using the keywords red eyes, and evaluation. What are your differential diagnoses and what further history will help you to. A focused history can help make a definitive diagnosis.
Authored by susan lightman posted on may 14, 2010 topic. The accuracy of the edinburgh red eye diagnostic algorithm. If you continue browsing the site, you agree to the use of cookies on this website. The red eye has an extensive differential diagnosis. Nov 05, 2018 exclude other potential causes of acute red eye, such as preseptal cellulitis or orbital cellulitis. Every physician has been faced with the symptom red eye 1 3. Downloaded from the american family physician web site at. Serious and potentially sightthreatening causes of red eye include. Although the exact incidence of diagnoses presenting as a red eye is not well defined, most are benign. Practioners are often confronted with a patient who presents. May 02, 2015 algorithm for the evaluation of the red eye 6. The accuracy of the edinburgh red eye diagnostic algorithm eye.
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. Medical student education 1 rating pdf 885 kb download susan lightman, frcp, frcophth, phd, professor of clinical ophthalmology at moorfields eye hospital, london, 2007. Conjunctivitis varies in severity from mild hyperemia with epiphora tearing to subconjunctival hemorrhage or chemosis conjunctival edema with copious purulent. Red eye severe pain in, around eye frontal headache blurred vision, halos seen around lights nausea, vomiting pupil fixed, middilated, slightly larger than contralateral side elevated iop corneal haze anterior segment disorders. It is frequently encountered in primary health care and emergency departments. Red eye diagnosis and management in primary health care. Diagnosis and management of red eye in primary care american. The red eye hsv keratitis anterior uveitis subconjunctival haemorrhage corneal ulcer episcleritis scleritis. There is a wide differential diagnosis for red eye. Differential diagnosis of red eye linkedin slideshare. Keratoconjunctivitis sicca kcs refers to any eye with some degree of dryness. Iceh 2006, international centre for eye health, london school of hygiene and tropical medicine, keppel street, london wc1e 7ht, uk.
Viral conjunctivitis most common cause of red eye allergic irritant conjunctivitis bacterial conjunctivitis neonatal conjunctivitis ophthalmia neonatorum. This should be an easy and excellent way of diagnosing any affection of the visual system. Uveitis is inflammation of the uveal tract, with or without inflammation of neighbouring structures e. Allergic rhinoconjunctivitis and differential diagnosis of. Important questions to ask in the history are shown in table 2.
The red appearance to the eye may be the first indication to the. Xerophthalmia describes a dry eye associated with vitamin a deficiency. Blepharitis, hordeolum, and chalazion are associated with a localized red, swol len, tender eyelid. Assessment of red eye differential diagnosis of symptoms. Pdf on may 1, 2011, khathutshelo percy mashige and others published differential diagnosis of red eye find, read and cite all the research you need on researchgate. Eye education for emergency clinicians 3 aims and objectives to have an understanding of the causes of the red eye objectives to be able to differentiate between common. Differential diagnosis of conjunctivitis and the red eye. Most cases will be due to relatively benign problems.
Selected differential diagnosis of red eye continued. The author, who is professor of ophthalmology at dusseldorf, west germany, has used an interesting and novel approach for the discussion of ocular diseases. Journal of pediatric ophthalmology and strabismus differential diagnosis of eye diseases, by hans pau, m. Differential diagnosis of red eye red eyes are commonly encountered in optometric practice and it is imperative that the eyecare practitioner is able to formulate an appropriate differential diagnosis in order to manage patients effectively and expeditiously. Download citation differential diagnosis of the swollen red eyelid the differential diagnosis of eyelid erythema and edema is broad, ranging from benign, selflimiting dermatoses to malignant. Red eye is a common presentation in clinical practice with conjunctivitis being the most common cause of red eye. The condition is usually benign and can be managed by primary care physicians. On examination, unaided visual acuity was 612 and 624 on the right and left eyes respectively, correcting with pinhole to 69 bilaterally. Differentiating urgent and emergent causes of acute red eye for. Pdf differential diagnosis of red eye researchgate. If youre stuck for a differential diagnosis, fall back on working through the anatomical components of the eye and running through a pathophysiological sieve. These can be classified according which structure is abnormal. Most commonly, conjunctivitis is infective bacterial and viral or allergic in origin although other forms of conjunctivitis including toxic and irritative conjunctivitis and conjunctivitis related to systemic conditions or dry eye are prevalent enough to warrant consideration in. More than meets the painful red eye case a man aged 49 years presented to a general practice facility with a painful red right eye and associated photophobia and epiphora.
Conjunctivitis accounts for over 25% of all eye complaints seen. Acute red eye is a common presenting complaint to primary care physicians. An edinburgh red eye diagnostic algorithm questionnaire was designed to evaluate the accuracy of the algorithmic assisted diagnosis in south east scotland. Acute anterior uveitis is the most common subtype and. Differential diagnosis of red eye slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising.
The first page of the pdf of this article appears above. The most frequently occurring differential diagnoses of red eye. Ppt red eye, a differential diagnosis powerpoint presentation free to download id. Eye education for emergency clinicians 4 introduction normally the eye has a strong resistance. For each sign and symptom, the differential diagnosis is discussed in detail. Red eye is one of the most important topics in medical practice. 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.
Mar 11, 2008 the differential diagnosis of the red eye. The epub format uses ebook readers, which have several ease of. Overview usually a self limiting benign disorder may be sight threatening may be the sentinel of a severe underlying. However, red eye can also be a feature of a more serious eye condition, in which a delay in treatment due to a missed diagnosis can result in permanent. Assessment of red eye differentials bmj best practice. Differential diagnosis of red eye with no injury management of a red. Macleods clinical diagnosis pdf 2nd edition free download. Medical student education 1 rating pdf 885 kb download. Viral conjunctivitis most common cause of red eye allergic irritant conjunctivitis bacterial conjunctivitis neonatal conjunctivitis ophthalmia neonatorum blepharitis hordeolum stye chalazion bacterial endophthalmitis fungal endophthalmitis keratitis corneal inflammation bacterial or viral. The differential diagnosis is so large that the caregiver must be comfortable with all diagnoses and must be able to distinguish between them.
Conjunctivitis is the most common cause of red eye. Red eye red eye is sign of pathology of anterior or posterior ocular segment, of orbit or of ocular adnexa. Download citation differential diagnosis of the swollen red eyelid the differential diagnosis of eyelid erythema and edema is broad, ranging from benign, selflimiting dermatoses to. Around 25% of general practice patients have an eye complaint featuring pain in and around the eye ocular, periocular, and. It is important to differentiate whether the person presenting with red eye needs same day assessment by an. Most commonly, conjunctivitis is infective bacterial and viral or allergic in. Diagnosis and management of pediatric conjunctivitis. In general emergency rooms or in hospitals without a consulting. Jul 27, 2015 red eye is a common presentation in primary care and is a sign of inflammation. Differential diagnosis of the red eye carol slight nurse practitioner ophthalmology. Differential diagnosis of red eye conjunctiva pupil cornea anterior chamber iop subconjunctival haemorrhage bright red normal normal normal normal conjunctivitis injected vessels. Discharge normal normal normal normal iritis injected around cornea small, fixed, irregular normal, kps turgid, deep normal. May 01, 2010 conjunctivitis varies in severity from mild hyperemia with epiphora tearing to subconjunctival hemorrhage or chemosis conjunctival edema with copious purulent discharge and concomitant eyelid edema.
Congenital dacryostenosis is another condition to consider in the differential diagnosis of neonatal conjunctivitis. Jan 15, 2010 red eye is the cardinal sign of ocular inflammation. A differential guide to 5 eye complaints mdedge family medicine. Diagnosis and management of red eye in primary care. 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. Practioners are often confronted with a patient who presents with the red eye. A detailed history of the presenting symptoms and previous ophthalmological and medical history can narrow the. Misdiagnosis is a major medicolegal pitfall, in that the truly emergent conditions that may cause red eye have major visionthreatening sequelae. Red eyes are commonly encountered in optometric practice and it is imperative that the eyecare practitioner is able to formulate an appropriate differential.
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. In the emergency department, 75% of ophthalmologic complaints are due to. This slide program provides an approach to differential diagnosis of. According to one study, eye problems are the reason for 2 to 3% of visits to primary care physicians and emergency facilities. The red eye international council of ophthalmology. Essentials of anatomy and physiology, examinations of the visual system, the child with suspected eye disease, chronic. Managing the red eye 4 introduction slide 1 physicians frequently encounter patients who complain of a red eye. The diagnosis of the cause of red eye can be a challenge for the pediatrician because the differential diagnosis includes a wide. This corresponds to an average of 4 to 10 patients every week, the majority of whom have clinically apparent red eye.
Red eye is a common presentation in primary care and is a sign of inflammation. Jun 11, 2019 the differential diagnosis is so large that the caregiver must be comfortable with all diagnoses and must be able to distinguish between them. Differential diagnosis of red eye conjunctiva pupil cornea anterior chamber iop subconjunctival haemorrhage bright red normal normal normal normal conjunctivitis injected vessels, fornices. Conjunctivitis can affect one or both eyes and is the most likely diagnosis. The differential diagnosis includes both benign and sightthreatening conditions. Differential diagnosis of the red eye in small animals. Patients commonly present with an acute red eye to the emergency. Eyelid swollen, red, differential diagnosis time of care.