10 Can’t Miss Diagnoses of the Red Eye
- Acute angle-closure glaucoma (AACG)
- Bacterial keratitis/ulcer
- Endophthalmitis
- Hyphema
- Hypopyon
- Iritis
- Infectious keratitis (bacterial and viral)
- Orbital cellulitis
- Scleritis
- Uveitis
A brief differential for a PAINFUL red eye based on symptom description**:**
- Itching => allergies
- Burning => lid disorders, dry eye
- FB sensation => FB, corneal abrasion
- Localized lid tenderness => hordeolum, chalazion
- Deep, intense pain => corneal abrasion, scleritis, iritis, acute glaucoma, sinusitis, orbital cellulitis
- Photophobia => corneal abrasions, iritis, acute glaucoma (think about ciliary body muscle spasm or other problems from the anterior segment of the eye)
- Halo vision => acute glaucoma, uveitis (resulting from corneal edema)
A brief differential for a PAINLESS red eye based on location**:**
- Diffusely red: conjunctivitis or episcleritis, but also consider eyelid abnormalities that may have an associated conjunctivitis (e.g., blepharitis, ectropion, entropion, eyelid lesion like tumor or stye)
- Localized redness: subconjunctival hemorrhage, pterygium, corneal foreign body (usually painful), ocular trauma (usually painful)