What are the differential diagnoses for a red eye?

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Last updated: February 17, 2025View editorial policy

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Red Eye Differential Diagnosis

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 crusting around the eyelashes.
    • Corneal abrasion: A scratch on the surface of the cornea, which can cause redness, pain, and sensitivity to light.
    • Uveitis: Inflammation of the uvea, the middle layer of the eye, which can cause redness, pain, and sensitivity to light.
  • Do Not Miss Diagnoses
    • Acute angle-closure glaucoma: A medical emergency characterized by sudden onset of severe eye pain, redness, and vision loss. If missed, it can lead to permanent vision loss.
    • Endophthalmitis: A severe infection within the eye, often following surgery or trauma, which can cause redness, pain, and vision loss. Prompt treatment is essential to preserve vision.
    • Orbital cellulitis: An infection of the tissues surrounding the eye, which can cause redness, swelling, and vision loss. If left untreated, it can lead to serious complications, including cavernous sinus thrombosis.
  • Rare Diagnoses
    • Scleritis: Inflammation of the sclera, the white part of the eye, which can cause redness, pain, and tenderness.
    • Episcleritis: Inflammation of the episclera, a thin layer of tissue on top of the sclera, which can cause redness and mild pain.
    • Keratitis: Inflammation of the cornea, which can cause redness, pain, and vision loss. It can be caused by infection, trauma, or other factors.
    • Carotid-cavernous fistula: An abnormal connection between the carotid artery and the cavernous sinus, which can cause redness, swelling, and vision loss.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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