Differential Diagnosis of Red Eye

Sub conjuntival haemorrhage Normal Usually aymptomatic No Deep red area under conj. Often sectorial Conjunctivitis Usually normal Burning, itching, irritation Mucous or mucopurulent Superficial/ diffuse of eye and eyelids conjunctiva Episcleritis Usually normal Sometimes irritation No Sectorial rednessengorgement of episcleral vessels Clear Scleritis Can have insidious Severe and boring pain. Tender to touch No Intensive injection of scleral, episcleral and conjunctival vessels. May have bluish hue Usually clear but may have peripheral keratitis May have associated inflammation Usually normal Usually normal Usually normal Usually normal but may be HSV keratitis May be reduced Mild to moderate Lacrimation sometimes Mild to moderate injection Corneal Ulcer May be markedly reduced Can be severe Anterior Uveitis May be decreased Moderately severe ache and photophobia Lacrimation Circum corneal Acute angle closure glaucoma Markedly reduced 6/60 and below Severe with headache, nausea, vomiting Lacrimation Marked circumcorneal

VA Pain

Discharge/ Lacrimation Hyperaemia

May be purulent Diffuse

Cornea

Clear

Usually clear but punctate staining at times Deep and quiet Normal Normal Normal Normal

Anterior chamber Iris Pupils Pupillary response Intraocular pressure

Deep and quiet Normal Normal Normal Normal

Quiet Normal Normal Normal Normal

Usually Area of corneal ulceration with fluorescein staining but not always Deep and usually quiet Normal Normal Normal Usually normal but may be high

Infiltrate with overlying epithelial defect

Precipitates may be present posterior surface Normal depth/ white blood cells May appear muddy coloured May be small and irregular May have sluggish reaction to light May be normal or or occ.

Usually cloudy

Deep. May have inflammatory cells/hypopyon Normal Usually normal Usually normal Usually normal

Shallow or flat May be difficult to see Semi dilated fixed Non reactive or minimal reaction Very high over 40 mmHg