Red Eye Differential Diagnosis and Treatment
The differential diagnosis for a red eye can be organized into the following categories:
- Single Most Likely Diagnosis
- Conjunctivitis: This is the most common cause of a red eye, often presenting with discharge, itching, and tearing. It can be viral, bacterial, or allergic in nature.
- Other Likely Diagnoses
- Dry Eye Syndrome: Characterized by a lack of sufficient lubrication on the surface of the eye, leading to redness, irritation, and sometimes a gritty sensation.
- Blepharitis: Inflammation of the eyelids, often associated with redness, itching, and swelling of the eyelid margins.
- Subconjunctival Hemorrhage: A condition where blood leaks underneath the conjunctiva, causing a sudden appearance of a red patch on the white of the eye, usually painless and resolving on its own.
- Do Not Miss Diagnoses
- Acute Angle-Closure Glaucoma: A medical emergency characterized by severe eye pain, redness, blurred vision, headache, and nausea. It requires immediate treatment to prevent permanent vision loss.
- Endophthalmitis: A severe inflammation of the interior of the eye, usually caused by infection. Symptoms include severe eye pain, redness, decreased vision, and swelling of the eyelids.
- Corneal Ulcer: An open sore on the cornea, often resulting from infection, which can lead to severe pain, redness, and vision loss if not promptly treated.
- Rare Diagnoses
- Scleritis: A severe inflammatory disease that affects the sclera (the white part of the eye), characterized by intense pain, redness, and tenderness to the touch.
- Uveitis: Inflammation of the uvea, the middle layer of the eye, which can cause redness, pain, and vision problems. It has various causes, including autoimmune disorders and infections.
- Keratitis: Inflammation of the cornea, which can be caused by infection or injury, leading to pain, redness, and vision disturbances.
Each diagnosis has distinct features and requires specific treatment approaches, ranging from topical medications for conjunctivitis and dry eye syndrome to urgent surgical intervention for conditions like acute angle-closure glaucoma. Accurate diagnosis is crucial for effective management and prevention of complications.