Skip to Main Content

++

Probability diagnosis

++

Conjunctivitis:

++

  • bacterial

  • adenovirus

  • allergic

++

Serious disorders not to be missed

++

Acute glaucoma

++

Uveitis:

++

  • acute iritis

  • choroiditis

++

Corneal ulcer

++

Corneal injury: abrasion/foreign body

++

Herpes simplex keratitis

++

Microbial keratitis (e.g. fungal, amoeba, bacterial)

++

Herpes zoster ophthalmicus

++

Penetrating injury

++

Endophthalmitis

++

Orbital cellulitis

++

Pitfalls (often missed)

++

Scleritis/episcleritis

++

Foreign body (esp. IOFB)

++

Trauma

++

Ultraviolet light ‘keratitis’

++

Blepharitis

++

Rarities:

++

  • cavernous sinus arteriovenous fistula

  • primary tumour of eye

++

Masquerades checklist

++

Drugs (hypersensitivity)

++

Thyroid disorder (hyperthyroidism)

++

Key history

++

The five essentials of the history are:

++

  • history of trauma, especially as indicator of intraocular foreign body (IOFB)

  • vision

  • the degree and type of discomfort

  • presence of discharge

  • presence of photophobia.

++

Consider association with spondyloarthropathies.

++

Key examination

++

When examining the unilateral red eye keep the following diagnoses in mind:

++

  • trauma

  • foreign body, including IOFB

  • corneal ulcer

  • iritis (uveitis)

  • viral conjunctivitis (commonest type)

  • acute glaucoma

++

The four essentials of the examination are:

++

  • testing and recording vision

  • meticulous inspection under magnification (slit lamp is ideal)

  • testing the pupils

  • testing ocular tension

++

Key investigations

++

  • May include swab of discharge for MC, visual acuity

  • ESR/CRP

  • HLAB27

  • Consider specialist referral

++

Diagnostic tips

++

  • A purulent discharge indicates bacterial conjunctivitis.

  • A clear or mucus discharge indicates viral or allergic conjunctivitis.

  • Be alert for the unilateral red eye: think beyond the conjunctivitis trio. It may be a corneal ulcer, keratitis, foreign body, trauma, uveitis or acute glaucoma.

Want remote access to your institution's subscription?

Sign in to your MyAccess profile while you are actively authenticated on this site via your institution (you will be able to verify this by looking at the top right corner of the screen - if you see your institution's name, you are authenticated). Once logged in to your MyAccess profile, you will be able to access your institution's subscription for 90 days from any location. You must be logged in while authenticated at least once every 90 days to maintain this remote access.

Ok

About MyAccess

If your institution subscribes to this resource, and you don't have a MyAccess profile, please contact your library's reference desk for information on how to gain access to this resource from off-campus.

Subscription Options

Murtagh Collection Full Site: One-Year Subscription

Connect to a suite of general practice resources from one of the most influential authors in the field. Learn the breadth of general practice, including up-to-date information on diagnosis and treatment, as well as key clinical skills like communication.

$145 USD
Buy Now

Pay Per View: Timed Access to all of Murtagh Collection

48 Hour Subscription $34.95

Buy Now

Pop-up div Successfully Displayed

This div only appears when the trigger link is hovered over. Otherwise it is hidden from view.