Red Eye

Age: ‍ years old

Gender: ‍malefemale



HISTORY:

Presents with a ‍-‍day history of ‍rightleftbilateral red eye

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

‍flashes

‍halo

‍fever, up to ‍°, over ‍ ‍hoursdays

‍runny nose, ‍clearcolored

‍cough, ‍non-productiveproductive of ‍clearcolored phlegm



Contributing factors:

‍similar symptoms in close contacts

‍allergies

‍exposure to sunlight or UV light

‍contact lens use

no history of: ‍allergic conjunctivitis, ‍dry eye syndrome, ‍keratitis, ‍cold sore, ‍glaucoma, ‍iritis, ‍systemic inflammatory disease

no use of: ‍new eye drops





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: viral conjunctivitis, bacterial conjunctivitis, allergic conjunctivitis, irritant conjunctivitis, dry eye syndrome, subconjunctival hemorrhage, acute angle-closure glaucoma, uveitis, keratitis, corneal abrasion, foreign body in the eye, blepharitis, scleritis, episcleritis, chemical burn, iritis, herpes simplex keratitis, herpes zoster ophthalmicus, endophthalmitis, orbital cellulitis, contact lens-related issues, pterygium, pinguecula





PLAN:

Investigations:

- Conjunctival swab for culture

Treatments:

- ‍Artificial tears

- ‍Ocular antibiotics

- ‍Ocular antihistamines

- ‍Ocular NSAIDs

- ‍Ocular lubricants

- Avoid touching or rubbing eyes

- Avoid contact lens use

- Hand hygiene education

- Cool compresses to eyes as needed

- Avoid contact with others

Further care:

- Referral to ophthalmology

- Follow-up in ‍ days

- Return if symptoms worsen or vision changes