Unilateral red eye: Difference between revisions

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==Trauma==
==Background==


==Clinical Features==
*Unilateral red/painful eye


A. Obvious open globe*
==Differential Diagnosis==
{{Unilateral red eye DDX}}


B. No obvious open globe
==Evaluation==
*Evert lid and look for [[ocular foreign body|foreign body]]
*Remove contacts
*Photophobia suggests inflammation i.e. [[uveitis]] and [[corneal abrasion|abrasions]]
*Pupil: irregular with positive sidel's suggests [[globe rupture|penetrating injury]]


    1. Epithelial defect
===Diagnostic Algorithm===
====Traumatic====
*Obvious [[Ruptured Globe]]^
*No obvious ruptured globe
**Epithelial defect
***[[Corneal Abrasion and Foreign Body]]
***[[Conjunctival laceration]]
***[[Corneal Ulcer]]^
***[[Caustic Keratoconjunctivitis]]^^
***Occult [[Ruptured Globe]]^
****(positive Sidel's)
**No defect
***[[Subconjunctival Hematoma]]
***[[Traumatic Iritis]]
***[[Hyphema]]^
****(?occult open globe)
***[[Endophthalmitis]]^
****(old occult open globe)


          i. Corneal abrasion
====Nontraumatic====
*Epithelial defect
**[[Corneal Abrasion]]
**[[Corneal Ulcer]]^
**[[Herpes Zoster Ophthalmicus]] (dendrite)
**Corneal erosion
***(morning pain)
**[[UV keratitis]]
***(SPK)
**Scleral penetration^
*No defect
**No pain relief with [[tropicamide]]
***[[Acute Angle Glaucoma]]^
****dilated
****closed angle
****inc pressure
***Nontraumatic [[Iritis]]
***[[Scleritis]]^
****(localized; no move Q-tip)
***Anterior [[Uveitis]]
****([[hypopyon]], ciliary flush)
**No pain '''OR''' pain relief with [[tropicamide]]
***[[ocular foreign body|Foreign body]]
***[[Conjunctivitis]]
***[[Keratoconjunctivitis]]
***[[Episcleritis]]
****(localized; move with Q-tip)
**Non-uptake finding (no pain/pain relief with tropicamide)
***[[Subconjunctival Hematoma]]
***Inflamed [[pinguecula]]
***Inflamed [[Pterygium]]
***Keratoconus (protrude)


          ii. Corneal ulcer*
^Emergent diagnoses


          iii. Caustic keratoconjunctivitis**
^^Critical diagnoses


          iv. Occult open globe*
==Management==
 
*By diagnosis
          (positive Sidel's)
 
    2. No defect
 
          i. Subconjunct hem
 
          ii. Traumatic iritis
 
          iii. Hypema*
 
          (?occult open globe)
 
          iv. Endophthalmitis*
 
          (old occult open globe)
 
 
==Nontraumatic==
 
 
A. Epithelial defect
 
    1. Corneal abrasion
 
    2. Corneal ulcer* (above)
 
    3. HSV conjunct (dendrite)
 
    4. Corneal erosion
 
    (morning pain)
 
    5. UV/welders keratitis
 
    (SPK)
 
    6. Scleral penetration*
 
B. No defect
 
    1. No pain relief w/ tropicamide
 
          i. Acute angle glaucoma*
 
              -dilated
 
              -closed angle
 
              -inc pressure
 
          ii. Nontraumatic Iritis
 
          iii. Scleritis*
 
          (localized; no move Q-tip)
 
          iv. Anterior uveitis
 
          (hypopyon, cilliary flush)
 
    2. No pain/pain relief w/ tropicamide
 
          i. Foreign body
 
          ii. Conjunctivitis
 
              a. Viral
 
              b. Bacterial*
 
              (purulent-->?GC)
 
              c. Allergic
 
              d. Contact
 
              e. Toxic
 
              f. Chlamydial
 
          iii. Keratoconjunctivits
 
          iv. Episcleritis
 
          (localized; move w/ Q-tip)
 
    3. Non-uptake finding
 
    (no pain/pain relief w/ tropicamd)
 
          i. Subconjunct hemorr
 
          ii. Inflamed pingueculum
 
          iii. Inflamed pterygium
 
          iv. Keratoconus (protrude)
 
 
*Emergent diagnosises
 
**Critical diagnosises
 


==See Also==
==See Also==
{{Eye algorithms}}


==References==
<references/>


Optho:  Corneal Abrasion vs Ulcer
[[Category:Ophthalmology]]
 
[[Category:Symptoms]]
Optho:  Red Eye (Unilateral) 2
 
Optho: Red Eye (Bilateral)
 
Optho:  Red Eye (by Sx)
 
 
==Source==
 
 
3/20/06 DONALDSON (adapted from Rosen, WMS Practic Guidelines 2000)
 
 
 
 
[[Category:Ophtho]]

Latest revision as of 15:45, 23 October 2019

Background

Clinical Features

  • Unilateral red/painful eye

Differential Diagnosis

Unilateral red eye

^Emergent diagnoses ^^Critical diagnoses

Evaluation

Diagnostic Algorithm

Traumatic

Nontraumatic

^Emergent diagnoses

^^Critical diagnoses

Management

  • By diagnosis

See Also

Eye Algorithms

References

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