Conjunctival or ciliary injection from a spectrum of causes ranging from benign conjunctivitis to sight-threatening emergencies.
Examination
- • Visual acuity in every patient
- • Pupil size and reaction
- • Fluorescein staining
- • Intraocular pressure if glaucoma suspected
Differential diagnosis
- • Conjunctivitis (viral/bacterial/allergic)
- • Keratitis and corneal ulcer
- • Anterior uveitis
- • Acute angle-closure glaucoma
- • Scleritis
- • Subconjunctival haemorrhage
Management
- • Conjunctivitis: hygiene, lubricants, antibiotic drops only if bacterial
- • Uveitis and keratitis: same-day ophthalmology referral
- • Contact-lens wearer with red eye = corneal ulcer until proven otherwise
Clinical pearls
- • Reduced acuity, photophobia or a hazy cornea means urgent referral
- • Never prescribe topical steroids without slit-lamp assessment
Educational — verify locally.
