Red Eye

CLINICAL DIAGNOSIS MANUAL

“Red eye” is a general term referring to the reddened appearance of the eye due to various causes. This sign can range from a simple irritation to a vision-threatening condition.

Pathology	Diagnosis of Suspicion	Diagnosis of Confirmation
Spontaneous Subconjunctival Haemorrhage	Bright red spot in the eye with no pain or visual impairment.	Clinical examination, generally a visual diagnosis; no additional tests required.
Bacterial Conjunctivitis	Red eye with purulent discharge, sticky eyelids, irritation.	Slit-lamp examination, culture of discharge if no response to initial treatment.
Viral Conjunctivitis	Red eye with watery discharge, cold symptoms, possible preauricular lymphadenopathy.	Clinical diagnosis; specific viral tests are rarely performed.
Allergic Conjunctivitis	Red eyes, intense itching, history of allergies, clear discharge.	Allergy testing if necessary, clinical diagnosis based on symptoms and allergen exposure.
Giant Papillary Conjunctivitis	Contact lens use, mucous discharge, large papillae on the tarsal conjunctiva.	Slit-lamp examination reveals typical papillary characteristics.
Corneal Ulcer	Severe pain, redness, blurred vision, often after trauma or in contact lens wearers.	Fluorescein staining shows corneal defect; corneal surface culture if infection is suspected.
Episcleritis	Localised redness, mild discomfort, no serious visual impairment.	Slit-lamp examination to confirm episcleral inflammation without scleral involvement.
Scleritis Associated with Connective Tissue Disease	Deep redness and pain, association with systemic autoimmune symptoms.	Slit-lamp examination, blood tests for autoimmune disease markers.
Closed-Angle Glaucoma	Severe eye pain, blurred vision, red eye, dilated non-reactive pupil.	Tonometry shows high intraocular pressure, confirmation with gonioscopy.
Iritis or Anterior Uveitis	Pain, photophobia, red eye, decreased vision.	Slit-lamp examination shows anterior segment inflammation, possible visual acuity test.