Unilateral red eye

Background

Clinical Features

Unilateral red/painful eye

Differential Diagnosis

Unilateral red eye

^Emergent diagnoses

^^Critical diagnoses

Evaluation

Evert lid and look for foreign body
Remove contacts
Photophobia suggests inflammation i.e. uveitis and abrasions
Pupil: irregular with positive sidel's suggests penetrating injury

Diagnostic Algorithm

Traumatic

Obvious Ruptured Globe^
No obvious ruptured globe
- Epithelial defect
  - Corneal Abrasion and Foreign Body
  - Conjunctival laceration
  - Corneal Ulcer^
  - Caustic Keratoconjunctivitis^^
  - Occult Ruptured Globe^
    - (positive Sidel's)
- No defect
  - Subconjunctival Hematoma
  - Traumatic Iritis
  - Hyphema^
    - (?occult open globe)
  - Endophthalmitis^
    - (old occult open globe)

Nontraumatic

Epithelial defect
- Corneal Abrasion
- Corneal Ulcer^
- Herpes Zoster Ophthalmicus (dendrite)
- Corneal erosion
  - (morning pain)
- UV keratitis
  - (SPK)
- Scleral penetration^
No defect
- No pain relief with tropicamide
  - Acute Angle Glaucoma^
    - dilated
    - closed angle
    - inc pressure
  - Nontraumatic Iritis
  - Scleritis^
    - (localized; no move Q-tip)
  - Anterior Uveitis
    - (hypopyon, ciliary flush)
- No pain OR pain relief with tropicamide
  - Foreign body
  - Conjunctivitis
  - Keratoconjunctivitis
  - Episcleritis
    - (localized; move with Q-tip)
- Non-uptake finding (no pain/pain relief with tropicamide)
  - Subconjunctival Hematoma
  - Inflamed pinguecula
  - Inflamed Pterygium
  - Keratoconus (protrude)

^Emergent diagnoses

^^Critical diagnoses

Management

By diagnosis

See Also

Eye Algorithms

References

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