Diagnosis and management of red eye in primary care.

Red eye is the cardinal sign of ocular inflammation. The condition is usually benign and can be managed by primary care physicians. Conjunctivitis is the most common cause of red eye. Other common causes include blepharitis, corneal abrasion, foreign body, subconjunctival hemorrhage, keratitis, iritis, glaucoma, chemical burn, and scleritis. Signs and symptoms of red eye include eye discharge, redness, pain, photophobia, itching, and visual changes. Generally, viral and bacterial conjunctivitis are self-limiting conditions, and serious complications are rare. Because there is no specific diagnostic test to differentiate viral from bacterial conjunctivitis, most cases are treated using broad-spectrum antibiotics. Allergies or irritants also may cause conjunctivitis. The cause of red eye can be diagnosed through a detailed patient history and careful eye examination, and treatment is based on the underlying etiology. Recognizing the need for emergent referral to an ophthalmologist is key in the primary care management of red eye. Referral is necessary when severe pain is not relieved with topical anesthetics; topical steroids are needed; or the patient has vision loss, copious purulent discharge, corneal involvement, traumatic eye injury, recent ocular surgery, distorted pupil, herpes infection, or recurrent infections.
AuthorsHolly Cronau, Ramana Reddy Kankanala, Thomas Mauger
JournalAmerican family physician (Am Fam Physician) Vol. 81 Issue 2 Pg. 137-44 (Jan 15 2010) ISSN: 1532-0650 [Electronic] United States
PMID20082509 (Publication Type: Journal Article, Review)
Chemical References
  • Anti-Bacterial Agents
  • Glucocorticoids
  • Algorithms
  • Anti-Bacterial Agents (therapeutic use)
  • Blepharitis (drug therapy, therapy)
  • Burns, Chemical (drug therapy, therapy)
  • Corneal Diseases (drug therapy, therapy)
  • Corneal Ulcer (drug therapy, therapy)
  • Diagnosis, Differential
  • Dry Eye Syndromes (drug therapy, therapy)
  • Endophthalmitis (drug therapy, therapy)
  • Eye Burns (drug therapy, therapy)
  • Eye Diseases (diagnosis, drug therapy, therapy)
  • Eye Foreign Bodies (drug therapy, therapy)
  • Eye Infections (drug therapy, therapy)
  • Eye Injuries (drug therapy, therapy)
  • Family Practice (methods)
  • Glaucoma (diagnosis, drug therapy)
  • Glucocorticoids (therapeutic use)
  • Humans
  • Keratoconjunctivitis (diagnosis, drug therapy)
  • Primary Health Care (methods)

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