Red eye (peds)
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Background
Clinical Features
Differential Diagnosis
- Corneal Abrasion and Foreign Body
- Corneal infection (consider herpes/chlamydia)
Unilateral red eye
- Nontraumatic
- Acute angle-closure glaucoma^
- Anterior uveitis
- Conjunctivitis
- Corneal erosion
- Corneal ulcer^
- Endophthalmitis^
- Episcleritis
- Herpes zoster ophthalmicus
- Inflamed pinguecula
- Inflamed pterygium
- Keratoconjunctivitis
- Keratoconus
- Nontraumatic iritis
- Scleritis^
- Subconjunctival hemorrhage
- Orbital trauma
- Caustic keratoconjunctivitis^^
- Corneal abrasion, Corneal laceration
- Conjunctival hemorrhage
- Conjunctival laceration
- Globe rupture^
- Hemorrhagic chemosis
- Lens dislocation
- Ocular foreign body
- Posterior vitreous detachment
- Retinal detachment
- Retrobulbar hemorrhage
- Traumatic hyphema
- Traumatic iritis
- Traumatic mydriasis
- Traumatic optic neuropathy
- Vitreous detachment
- Vitreous hemorrhage
- Ultraviolet keratitis
^Emergent diagnoses ^^Critical diagnoses
Bilateral red eyes
- Painful
- Painless
Evaluation
- EXAM: Fluorescein to rule out corneal abrasion and herpes keratitis
Management
- Infectious: oral erythromycin + ceftriaxone (for N. gonorrhoeae)
- Conjunctivitis + respiratory symptoms/abnormal CXR or otitis media: (if younger than 3 mos) oral macrolide
Disposition
See Also
Eye Algorithms
- Red eye
- Periorbital swelling
- Acute vision loss (noninflamed)
- Acute onset flashers and floaters
- Painful eyes with normal exam