From the Guidelines
Tenderness to eye palpation is most likely caused by an inflammatory or infectious condition, such as conjunctivitis or keratitis, and requires prompt medical attention to prevent further complications. The most recent and highest quality study, 1, suggests that conjunctivitis, particularly viral adenoviral conjunctivitis, is a common cause of eye tenderness, characterized by abrupt onset, unilateral or bilateral bulbar conjunctival injection, watery discharge, and follicular reaction. Other potential causes of eye tenderness include orbital cellulitis, glaucoma, uveitis, orbital fracture, or foreign body presence.
Key factors to consider when evaluating eye tenderness include:
- Clinical signs, such as bulbar conjunctival injection, watery discharge, and follicular reaction
- Associated or predisposing factors, such as exposure to infected individuals, recent ocular testing, or concurrent upper respiratory infections
- Natural history of the condition, including self-limiting or potentially severe sequelae
- Potential sequelae, such as conjunctival scarring, symblepharon, keratitis, and subepithelial corneal infiltrates
While waiting for medical care, it is essential to avoid touching or rubbing the eye, not apply pressure, and not use eye drops unless prescribed. Over-the-counter pain relievers like acetaminophen may provide temporary relief, but they do not address the underlying cause. Prompt medical evaluation by an ophthalmologist or emergency room is crucial to determine the underlying cause of eye tenderness and prevent further complications, as supported by 1 and 1.
From the Research
Causes of Tender Palpation of the Eye
- Orbital cellulitis is a medical emergency that can cause tender palpation of the eye 2
- The infection can lead to inflammation and swelling, resulting in pain and tenderness in the orbital area 3
- The cause of orbital cellulitis can be related to acute sinusitis, and it is more common in the pediatric population 4
- Tender palpation of the eye can be a symptom of orbital cellulitis, which requires prompt diagnosis and treatment to avoid serious complications 5
- The infection can be managed with antibiotics, and in some cases, surgical intervention may be necessary 6, 4
Related Conditions
- Periorbital cellulitis can progress to orbital cellulitis, causing tender palpation of the eye 3
- Subperiosteal abscess and cavernous sinus thrombosis are complications of orbital cellulitis that can cause severe pain and tenderness 4
- Exposure keratopathy is a potential complication of orbital cellulitis that can cause discomfort and pain in the eye 3
Diagnosis and Treatment
- Early diagnosis and intervention are crucial in managing orbital cellulitis and preventing serious complications 2, 4
- A comprehensive algorithm for management of pediatric orbital cellulitis has been developed, including criteria for age, location, and volume of abscess on imaging 4
- Corticosteroids may be used as an adjunctive treatment for orbital cellulitis, but there is insufficient evidence to draw conclusions about their effectiveness 3