Red Eye

When you are evaluating a patient with an acute red eye the presence or absence of pain is a very important feature - Megan Boysen Osborn MD

Red Eye
Red Eye

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How to Triage the Painful Red Eye: Considerations for Non-Ophthalmic Providers

One of the most helpful differentiating symptoms of a red eye... is pain. In general, the non-painful red eye denotes a less serious, non-vision threatening cause... Furthermore, patients who wear contact lenses and have a red eye with or without pain should also be considered high risk patients and warrant urgent evaluation.

Painful red eye

Proptosis, conjunctival injection, limited ocular motility and pain are highly suggestive of inflammatory orbital diseases such as... orbital cellulitis...

Pain, diffuse conjunctival injection, high intraocular pressures (IOP), mid-dilated pupil, in a patient who is nauseous or may be vomiting are…

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 How to Triage the Painful Red Eye: Considerations for Non-Ophthalmic Providers

One of the most helpful differentiating symptoms of a red eye, also called injection, is pain. In general, the non-painful red eye denotes a less serious, non-vision threatening cause. A painful red eye is often a more serious problem. Furthermore, patients who wear contact lenses and have a red eye with or without pain should also be considered high risk patients and warrant urgent evaluation.

Core EM

Intraocular pressure measurements. Apply your topical anesthetic prior to performing a pressure assessment. Measure the unaffected eye as well for control. Normal IOP = 12 to 22 mmHg. Used primarily to identify or rule out AACG and other etiologies that may increase pressures behind the eye (e.g., orbital cellulitis, cavernous sinus thrombosis, retrobulbar hematoma).

International Emergency Medicine Education Project

The application of topical anesthetics to the eye helps to differentiate between superficial and deeper causes of pain. Pain that is not completely relieved by topical anesthetics is more likely to be from the sclera or anterior chamber.

EMed

The four main causes of acute red eye presenting to the ED are Conjunctivitis - Inflammation outer eye, Iritis - Inflammation inner eye, Glaucoma - Aqueous outflow blockage, Keratitis - Corneal ulcer = combination of conjunctivitis and Iritis.

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