Differential Diagnosis for a Red Eye Requiring Immediate Ophthalmologic Referral
- Single Most Likely Diagnosis
- Acute Angle-Closure Glaucoma: This condition is characterized by sudden, severe eye pain, redness, blurred vision, and often accompanied by nausea and vomiting. It is a medical emergency because prompt treatment is necessary to prevent permanent vision loss.
- Other Likely Diagnoses
- Corneal Ulcer: A serious infection of the cornea that can lead to vision loss if not treated promptly. Symptoms include severe eye pain, redness, and decreased vision.
- Endophthalmitis: A severe inflammation of the interior of the eye, usually caused by infection. It presents with severe eye pain, redness, and decreased vision, and requires immediate treatment to preserve vision.
- Chemical Burn: Exposure to caustic substances can cause severe damage to the eye, leading to redness, pain, and potential vision loss. Immediate flushing and medical attention are crucial.
- Do Not Miss Diagnoses
- Retinal Detachment: Although it may not always present with a red eye, it is a vision-threatening condition that requires urgent treatment. Symptoms can include sudden flashes of light, floaters, and a curtain or shadow descending over the field of vision.
- Orbital Cellulitis: An infection of the tissues surrounding the eye, which can lead to serious complications if not treated promptly. Symptoms include swelling, redness, and pain around the eye, and sometimes decreased vision.
- Rare Diagnoses
- Scleritis: A severe inflammation of the sclera (the white part of the eye), which can be extremely painful and may lead to vision loss if not treated. It is less common than other causes of red eye but requires immediate attention due to its potential for serious complications.
- Uveitis: Inflammation of the uvea, the middle layer of the eye, which can cause severe eye pain, redness, and sensitivity to light. While not all cases are emergencies, certain types and presentations may require urgent ophthalmologic evaluation.