Red eye (medicine)
 | This article may be too technical for most readers to understand. (April 2012) |
| Red eye | |
|---|---|
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| Subconjunctival hemorrhage causing red coloration as result of ruptured blood vessel in the eye | |
| Specialty | Ophthalmology  |
A red eye is an
Management includes assessing whether emergency action (including referral) is needed, or whether treatment can be accomplished without additional resources.
Diagnosis
Particular
Seven such signs are:
- Reduced visual acuity
- Ciliary flush (circumcorneal injection)
- Corneal abnormalities including edema or opacities ("corneal haze")
- Corneal staining
- Pupil abormalities including abormal pupil size
- Abnormal intraocular pressure
- Severe pain
The most useful is a smaller pupil in the red eye than the non-red eye (opposite eye) and sensitivity to bright light.[2]
Reduced visual acuity
A reduction in
Ciliary flush
Ciliary flush is usually present in eyes with corneal inflammation, iridocyclitis or
Corneal abnormalities
The cornea is required to be transparent to transmit light to the retina. Because of injury, infection or inflammation, an area of opacity may develop which can be seen with a penlight or slit lamp. In rare instances, this opacity is congenital.[4] In some, there is a family history of corneal growth disorders which may be progressive with age. Much more commonly, misuse of contact lenses may be a precipitating factor. Whichever, it is always potentially serious and sometimes necessitates urgent treatment and corneal opacities are the fourth leading cause of blindness.
Opacities may be keratic, that is, due to the deposition of inflammatory cells, hazy, usually from corneal edema, or they may be localized in the case of corneal ulcer or keratitis.
Corneal epithelial disruptions may be detected with fluorescein staining of the eye, and careful observation with cobalt-blue light.
Corneal epithelial disruptions would stain green, which represents some injury of the corneal epithelium.
These types of disruptions may be due to
Pupillary abnormalities
In an eye with iridocyclitis, (inflammation of both the iris and ciliary body), the involved
Shallow anterior chamber depth may indicate a predisposition to one form of glaucoma (narrow angle) but requires
Abnormal intraocular pressure
Intraocular pressure should be measured as part of a routine eye examination. It is usually only elevated by iridocyclitis or acute-closure glaucoma, but not by relatively benign conditions. In iritis and traumatic perforating ocular injuries, the intraocular pressure is usually low.
Severe pain
Those with
Differential diagnosis
Of the many causes, conjunctivitis is the most common.[1] Others include:
Usually nonurgent
- airborne eye irritants
- blepharitis[5] – a usually chronic inflammation of the eyelids with scaling, sometimes resolving spontaneously
- drugs: medications or recreational drug use
- dry eye syndrome – caused by either decreased tear production or increased tear film evaporation which may lead to irritation and redness [8]
Acute glaucoma, angle closure type - subconjunctival hemorrhage[1]– a sometimes dramatic, but usually harmless, bleeding underneath the conjunctiva most often from spontaneous rupture of the small, fragile blood vessels, commonly from a cough or sneeze
- inflamed pterygium[9]– a benign, triangular, horizontal growth of the conjunctiva, arising from the inner side, at the level of contact of the upper and lower eyelids, associated with exposure to sunlight, low humidity and dust. It may be more common in occupations such as farming and welding.
- inflamed pinguecula[10] – a yellow-white deposit close to the junction between the cornea and sclera, on the conjunctiva. It is most prevalent in tropical climates with much UV exposure. Although harmless, it can occasionally become inflamed.
- tiredness
- episcleritis[11] – most often a mild, inflammatory disorder of the 'white' of the eye unassociated with eye complications in contrast to scleritis, and responding to topical medications such as anti-inflammatory drops.
Usually urgent
- acute closed-angle glaucoma[12]– implies injury to the optic nerve with the potential for irreversible vision loss which may be permanent unless treated quickly, as a result of increased pressure within the eyeball. Not all forms of glaucoma are acute, and not all are associated with increased intraocular pressure.
- eye injury
- keratitis[12] – a potentially serious inflammation or injury to the cornea (window), often associated with significant pain, light intolerance, and deterioration in vision. Numerous causes include virus infection. Injury from contact lenses can lead to keratitis.
- , part of the middle, pigmented, structures of the eye. Inflammation of this layer (uveitis) requires urgent control and is estimated to be responsible for 10% of blindness in the United States.
- autoimmunecondition.
- tick-borne illnesses like Rocky Mountain spotted fever[14] – the eye is not primarily involved, but the presence of conjunctivitis, along with fever and rash, may help with the diagnosis in appropriate circumstances.
See also
References
- ^ PMID 20082509.
- PMID 26169885.
- PMID 10922425.
- S2CID 9031282.
- PMID 18347619.
- PMID 18725316.
- ^ American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR). Washington DC: American Psychiatric Association; 2000.
- ^ "Keratoconjunctivitis, Sicca". eMedicine. WebMD, Inc. January 27, 2010. Retrieved September 3, 2010.
- S2CID 15507689.
- ISBN 1-56055-814-8.
- PMID 11024419.
- ^ PMID 18249263.
- S2CID 37084152.
- ^ https://www.cdc.gov/mmwr/pdf/rr/rr5504.pdf [bare URL PDF]
External links
