Everything about Red Eye Medicine totally explained
In
medicine,
red eye is a non-specific term to describe an
eye that appears
red due to illness, injury, or some other condition. "Conjunctival injection" and "bloodshot eyes" are two forms of red eye.
Since it's a common affliction, it's unsurprising that
primary care doctors often deal with
patients with red eyes in their practices.
The goal of the primary care doctor when presented with a red eye is to assess whether it's an
emergency in need of referral and immediate action, or instead a benign condition that can be managed easily and effectively.
Red eye usually refers to
hyperemia of the superficial
blood vessels of the
conjunctiva,
sclera or
episclera, and may be caused by
diseases or disorders of these structures or adjacent structures that may affect them directly or indirectly.
Causes
There are many causes of a red eye including
conjunctivitis,
blepharitis, acute
glaucoma,
injury,
subconjunctival hemorrhage, inflamed
pterygium, inflamed
pinguecula,
dry eye syndrome, and drug use including cannabis.
Investigation
Some
signs and
symptoms of red eye represent warnings that the underlying cause is serious and requires immediate attention.
The
person conducting a thorough
eye examination should be attentive to the warning signs and symptoms during the eye exam.
There are six danger signs: conjunctival injection, ciliary flush (circumcorneal injection), corneal edema or opacities, corneal staining, abnormal pupil size, and abnormal intraocular pressure.
Visual acuity
Reduced visual acuity is indicative of serious ocular disease, such as
corneal inflammation,
iridocyclitis, and
glaucoma, and never occurs in simple
conjunctivitis without concurrent corneal involvement.
Ciliary flush
Ciliary flush is usually present in eyes with corneal inflammation, iridocyclitis or
acute glaucoma, though not simple conjunctivitis.
A ciliary flush is a ring of
red or
violet around the
cornea of the eye.
Corneal opacification
Corneal opacities always indicate that a serious disease process is in progress.
Opacification may be detected using an
ophthalmoscope or, in more obvious cases, with a pen light.
These opacities may be keratic, haze-like (usually from corneal
edema), or they may be localized such as with
ulcerated corneas or those affected by
keratitis.
Corneal epithelial disruption
Corneal epithelial disruptions may be detected with
fluorescein staining of the eye, and careful observation with
cobalt-
blue light.
Corneal epithelial disruptions would stain
green, which represents some injury of the corneal epithelium.
These types of disruptions may be due to
corneal inflammations or
physical trauma to the cornea.
Pupillary abnormalities
An eye with iridocyclitis would have one
pupil that's smaller than the other, which is caused by a
reflex muscle spasm of the
iris sphincter muscle.
As is the general rule, conjunctivitis doesn't affect the pupils.
With acute angle-closure glaucoma, the pupil would be partially dilated and oval.
Shallow anterior chamber depth
Shallow anterior chamber depth usually indicates some problem.
If the eye is red, anterior chamber depth may indicate acute
glaucoma, which requires immediate attention.
Abnormal intraocular pressure
Intraocular pressure should be measured as part of the routine
eye examination.
It is usually affected only by iridocyclitis or acute-closure glaucoma, but not by relatively benign conditions.
In iritis and traumatic perforating ocular injuries, pressure is usually low.
Proptosis
Proptosis, or forward displacement of the globe, may be caused by an
infection of the
orbit, or a cavernous sinus disease.
Most commonly, chronic proptosis is caused by
thyroid diseases such as
Graves disease.
Important warning symptoms
There are three main danger symptoms in a red eye: reduced visual acuity, severe ocular pain, and photophobia (light sensitivity).
Blurry vision
Blurry vision often indicates serious ocular disease.
If the blurriness improves with
blinking, it suggests ocular surface discharge of some variety.
Severe pain
Those suffering from
conjunctivitis may report mild irritation or scratchiness, but never extreme
pain.
Severe pain is an indicator of
keratitis, corneal ulceration,
iridocyclitis, or acute
glaucoma.
Photophobia
Photophobia, or fear of
light, is usually an indication of
iritis.
Coloured halos
Coloured
halos are an indication of
corneal edema, and are a warning that acute glaucoma may be present.
Further Information
Get more info on 'Red Eye Medicine'.
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