What are the causes of a red, painful eye?

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Last updated: May 2, 2025View editorial policy

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Differential Diagnosis for Red Painful Eye

  • Single most likely diagnosis
    • Conjunctivitis: This is the most common cause of a red painful eye, often due to viral or bacterial infections, and is characterized by redness, discharge, and irritation.
  • Other Likely diagnoses
    • Dry eye syndrome: This condition can cause eye pain, redness, and irritation due to insufficient tear production or poor tear quality.
    • Blepharitis: Inflammation of the eyelids can cause redness, itching, and pain, often associated with bacterial or demodex mite infestations.
    • Corneal abrasion or ulcer: Damage to the cornea can cause severe pain, redness, and sensitivity to light, often due to trauma, contact lens use, or infection.
    • Uveitis: Inflammation of the uvea can cause eye pain, redness, and sensitivity to light, often associated with autoimmune disorders or infections.
  • Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
    • Acute angle-closure glaucoma: A medical emergency characterized by sudden onset of severe eye pain, redness, and vision loss, requiring immediate treatment to prevent permanent vision loss.
    • Endophthalmitis: A severe infection within the eye that can cause pain, redness, and vision loss, often following eye surgery or trauma.
    • Orbital cellulitis: A bacterial infection of the tissues surrounding the eye that can cause pain, redness, and swelling, potentially leading to serious complications if left untreated.
  • Rare diagnoses
    • Scleritis: Inflammation of the sclera can cause severe eye pain, redness, and tenderness, often associated with autoimmune disorders.
    • Keratitis: Inflammation of the cornea can cause pain, redness, and vision loss, often due to infection or autoimmune disorders.
    • Ocular migraine: A condition characterized by recurrent episodes of eye pain, redness, and visual disturbances, often associated with migraine headaches.

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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