Bilateral Red Eyes

Age: ‍ years old

Gender: ‍malefemale



HISTORY:

Presents with a ‍-‍day history of bilateral red eyes

Onset was ‍gradualsudden, started ‍whileafter ‍ ‍spontaneoustraumaforeign bodygrindingUV exposure

Worsening factors: ‍none

Alleviating factors: ‍none, ‍effectiveineffective



Associated symptoms: *Try using right-click for negatives*

‍discharge

‍tearing

‍eye discomfort

‍eye pain

‍itching

‍foreign body sensation

‍photophobia

‍blurred vision

‍vision loss

‍eyelid swelling

‍fever, up to ‍°, over ‍ ‍hoursdays

‍runny nose, ‍clearcolored

‍cough, ‍non-productiveproductive of ‍clearcolored phlegm



Contributing factors:

‍similar symptoms in close contacts

‍exposure to sunlight or UV light

‍contact lens use

no history of: ‍allergic conjunctivitis, ‍dry eye syndrome, ‍allergies

no use of: ‍new eyedrops





EXAM:

Eyes: ‍rightleftbilaterally

- Eyelids/lashes: ‍normal, ‍

- Conjunctiva/sclera: ‍normal, ‍

- Cornea: ‍clear, ‍

- Anterior chamber: ‍not performed, ‍clear

- Pupil: ‍equal, round, and reactive to light and accommodation (PERRLA)

- Extraocular movements: ‍intact

- Visual fields: ‍full, ‍

- Intraocular pressure: right ‍ mmHg, left ‍ mmHg, ‍normalnot performed

- Fundoscopy: ‍normal, ‍

- Visual acuity: right 20/‍, left 20/‍





ASSESSMENT:

‍Conjunctivitis ‍likelysuspectedpossible

DDx: conjunctivitis (allergic, bacterial, viral), dry eye syndrome, subconjunctival hemorrhage, keratitis, iritis, uveitis, episcleritis, scleritis, corneal abrasion, corneal ulcer, foreign body in the eye, chemical burn, blepharitis, meibomian gland dysfunction, orbital cellulitis





PLAN:

Treatments:

- Avoid touching or rubbing eyes

- Hand hygiene education

- Cool compresses to eyes as needed

- Artificial tears QID

- ‍Ocular antibiotics

Further care:

- Follow-up in ‍ days if no improvement

- Return if symptoms worsen or vision changes

- Referral to ophthalmology if no improvement