Unilateral red eye: Difference between revisions
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{{Unilateral red eye DDX}} | {{Unilateral red eye DDX}} | ||
== | ==Evaluation== | ||
*Evert | *Evert lid and look for [[ocular foreign body|foreign body]] | ||
*Remove contacts | *Remove contacts | ||
*Photophobia suggests inflammation i.e. uveitis and abrasions | *Photophobia suggests inflammation i.e. [[uveitis]] and [[corneal abrasion|abrasions]] | ||
*Pupil: irregular with positive sidel's suggests penetrating injury | *Pupil: irregular with positive sidel's suggests [[globe rupture|penetrating injury]] | ||
===Diagnostic | ===Diagnostic Algorithm=== | ||
====Traumatic==== | ====Traumatic==== | ||
* Obvious [[Ruptured Globe]]^ | *Obvious [[Ruptured Globe]]^ | ||
* No obvious ruptured globe | *No obvious ruptured globe | ||
** Epithelial defect | **Epithelial defect | ||
*** [[Corneal Abrasion and Foreign Body]] | ***[[Corneal Abrasion and Foreign Body]] | ||
***[[Conjunctival laceration]] | ***[[Conjunctival laceration]] | ||
*** [[Corneal Ulcer]]^ | ***[[Corneal Ulcer]]^ | ||
*** [[Caustic Keratoconjunctivitis]]^^ | ***[[Caustic Keratoconjunctivitis]]^^ | ||
*** Occult [[Ruptured Globe]]^ | ***Occult [[Ruptured Globe]]^ | ||
****(positive Sidel's) | ****(positive Sidel's) | ||
** No defect | **No defect | ||
*** [[Subconjunctival Hematoma]] | ***[[Subconjunctival Hematoma]] | ||
*** [[Traumatic Iritis]] | ***[[Traumatic Iritis]] | ||
*** | ***[[Hyphema]]^ | ||
****(?occult open globe) | ****(?occult open globe) | ||
*** [[Endophthalmitis]]^ | ***[[Endophthalmitis]]^ | ||
**** (old occult open globe) | ****(old occult open globe) | ||
====Nontraumatic==== | ====Nontraumatic==== | ||
* Epithelial defect | *Epithelial defect | ||
** [[Corneal Abrasion]] | **[[Corneal Abrasion]] | ||
** [[Corneal Ulcer]]^ | **[[Corneal Ulcer]]^ | ||
** [[Herpes Zoster Ophthalmicus]] (dendrite) | **[[Herpes Zoster Ophthalmicus]] (dendrite) | ||
** Corneal erosion | **Corneal erosion | ||
***(morning pain) | ***(morning pain) | ||
** [[UV keratitis]] | **[[UV keratitis]] | ||
*** (SPK) | ***(SPK) | ||
** Scleral penetration^ | **Scleral penetration^ | ||
* No defect | *No defect | ||
** No pain relief | **No pain relief with [[tropicamide]] | ||
*** [[Acute Angle Glaucoma]]^ | ***[[Acute Angle Glaucoma]]^ | ||
****dilated | ****dilated | ||
****closed angle | ****closed angle | ||
****inc pressure | ****inc pressure | ||
*** Nontraumatic Iritis | ***Nontraumatic [[Iritis]] | ||
*** [[Scleritis]]^ | ***[[Scleritis]]^ | ||
****(localized; no move Q-tip) | ****(localized; no move Q-tip) | ||
*** Anterior [[Uveitis]] | ***Anterior [[Uveitis]] | ||
****(hypopyon, | ****([[hypopyon]], ciliary flush) | ||
** No pain OR pain relief | **No pain '''OR''' pain relief with [[tropicamide]] | ||
*** Foreign body | ***[[ocular foreign body|Foreign body]] | ||
*** [[Conjunctivitis]] | ***[[Conjunctivitis]] | ||
*** [[ | ***[[Keratoconjunctivitis]] | ||
*** [[Episcleritis]] | ***[[Episcleritis]] | ||
****(localized; move | ****(localized; move with Q-tip) | ||
** Non-uptake finding (no pain/pain relief | **Non-uptake finding (no pain/pain relief with tropicamide) | ||
*** [[Subconjunctival Hematoma]] | ***[[Subconjunctival Hematoma]] | ||
*** Inflamed | ***Inflamed [[pinguecula]] | ||
*** Inflamed [[Pterygium]] | ***Inflamed [[Pterygium]] | ||
*** Keratoconus (protrude) | ***Keratoconus (protrude) | ||
^Emergent | ^Emergent diagnoses | ||
^^Critical | ^^Critical diagnoses | ||
== | ==Management== | ||
*By diagnosis | *By diagnosis | ||
==See Also== | ==See Also== | ||
{{Eye algorithms}} | |||
== | ==References== | ||
<references/> | |||
[[Category: | [[Category:Ophthalmology]] | ||
[[Category:Symptoms]] | |||
Latest revision as of 15:45, 23 October 2019
Background
Clinical Features
- Unilateral red/painful eye
Differential Diagnosis
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
Evaluation
- Evert lid and look for foreign body
- Remove contacts
- Photophobia suggests inflammation i.e. uveitis and abrasions
- Pupil: irregular with positive sidel's suggests penetrating injury
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)
- Epithelial defect
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)
- Acute Angle Glaucoma^
- No pain OR pain relief with tropicamide
- 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)
- No pain relief with tropicamide
^Emergent diagnoses
^^Critical diagnoses
Management
- By diagnosis
See Also
Eye Algorithms
- Red eye
- Periorbital swelling
- Acute vision loss (noninflamed)
- Acute onset flashers and floaters
- Painful eyes with normal exam
- Neonatal eye problems