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Red Eye Assessment and Management

Acute red eye is a common presenting complaint to primary care physicians. A detailed history of the presenting symptoms and previous ophthalmic and medical history can narrow the differential diagnosis and aid in the interpretation of key examination findings. The lack of specialist equipment in the primary care setting, along with a very broad differential diagnosis, can cause difficulty in establishing the correct diagnosis, and in such cases a specialist ophthalmic opinion should be sought. Serious vision-threatening conditions that present as red eye are rare and can occasionally be overshadowed by associated systemic symptoms; in light of this they should always be considered within the differential and excluded on examination.

Many patients with a red eye call to inquire whether they need to be seen by a clinician. Certain historical features or presenting complaints signal the need for clinician examination and possibly patient referral. The following questions should be asked in all patients. Many cases can be handled by primary care providers by telephone or telemedicine (video) or by having the patient send phone images.

Causes of Red Eye

Conjunctivitis is the maximum not unusualplace motive of purple eye and is one of the main indicators for antibiotics.1 Causes of conjunctivitis can be infectious (e.g., viral, bacterial, chlamydial) or noninfectious (e.g., allergic reactions, irritants).2 Most instances of viral and bacterial conjunctivitis are self-limiting. Other not unusualplace reasons of purple eye consist of blepharitis, corneal abrasion, overseas body, subconjunctival hemorrhage, keratitis, iritis, glaucoma, chemical burn, and scleritis.

A thorough affected person records and eye exam may also offer clues to the etiology of purple eye (Figure 1). The records need to consist of questions on unilateral or bilateral eye involvement, length of symptoms, kind and quantity of discharge, visible changes, severity of pain, photophobia, preceding treatments, presence of allergic reactions or systemic disease, and the usage of touch lenses. The eye exam need to consist of the eyelids, lacrimal sac, scholar length and response to light, corneal involvement, and the sample and vicinity of hyperemia. Preauricular lymph node involvement and visible acuity need to additionally be assessed

Diagnosis and Treatment


Viral conjunctivitis as a result of the adenovirus is pretty contagious, while conjunctivitis as a result of different viruses (e.g., herpes simplex virus [HSV]) are much less probably to unfold. Viral conjunctivitis normally spreads via direct touch with infected fingers, clinical devices, swimming pool water, or private items. It is regularly related to an higher respiration contamination unfold via coughing. The scientific presentation of viral conjunctivitis is normally moderate with spontaneous remission after one to 2 weeks.Treatment is supportive and can consist of bloodless compresses, ocular decongestants, and synthetic tears. Topical antibiotics are not often essential due to the fact secondary bacterial infections are uncommon.
To save you the unfold of viral conjunctivitis, sufferers ought to be advised to exercise strict hand washing and keep away from sharing private items; meals handlers and fitness care people ought to now no longer paintings till eye discharge ceases; and physicians ought to easy devices after each use. Referral to an ophthalmologist is essential if signs do now no longer solve after seven to ten days or if there’s corneal involvement.Topical corticosteroid remedy for any motive of pink eye is used handiest below direct supervision of an ophthalmologist. Suspected ocular herpetic contamination additionally warrants on the spot ophthalmology referral.


Bacterial conjunctivitis is surprisingly contagious and is maximum typically unfold thru direct touch with infected fingers. Based on length and severity of symptoms and symptoms and signs and symptoms, bacterial conjunctivitis is labeled as hyperacute, acute, or persistent.
Hyperacute bacterial conjunctivitis is regularly related to Neisseria gonorrhoeae in sexually energetic adults. The contamination has a surprising onset and progresses rapidly, main to corneal perforation. Hyperacute bacterial conjunctivitis is characterised through copious, purulent discharge; pain; and faded imaginative and prescient loss. Patients want spark off ophthalmology referral for competitive management. Acute bacterial conjunctivitis is the maximum not unusualplace shape of bacterial conjunctivitis withinside the number one care setting. Signs and signs and symptoms persist for much less than 3 to 4 weeks. Staphylococcus aureus contamination regularly reasons acute bacterial conjunctivitis in adults, while Streptococcus pneumoniae and Haemophilus influenzae infections are extra not unusualplace reasons in children. Chronic bacterial conjunctivitis is characterised through symptoms and symptoms and signs and symptoms that persist for as a minimum 4 weeks with common relapses.Patients with persistent bacterial conjunctivitis have to be cited an ophthalmologist.


Chlamydial conjunctivitis need to be suspected in sexually energetic sufferers who’ve usual symptoms and symptoms and signs and do now no longer reply to traditional antibacterial treatment. Patients with chlamydial contamination additionally may also gift with continual follicular conjunctivitis. Polymerase chain response checking out of conjunctival scrapings is diagnostic, however isn’t generally needed. Treatment consists of topical remedy with erythromycin ophthalmic ointment, and oral remedy with azithromycin (Zithromax; unmarried 1-g dose) or doxycycline (a hundred mg two times an afternoon for 14 days) to clean the genital contamination. The patient’s sexual companions additionally ought to be treated.


Allergic conjunctivitis is frequently related to atopic diseases, consisting of allergic rhinitis (maximum not unusualplace), eczema, and asthma. Ocular hypersensitive reactions have an effect on an predicted 25 percentage of the populace withinside the United States. Itching of the eyes is the maximum obvious characteristic of allergic conjunctivitis. Seasonal allergic conjunctivitis is the maximum not unusualplace shape of the condition, and signs and symptoms are associated with season-precise aeroallergens. Perennial allergic conjunctivitis persists for the duration of the year. Allergic conjunctivitis is in most cases a medical diagnosis.
Avoiding publicity to allergens and the use of synthetic tears are powerful techniques to relieve signs and symptoms. Over-the-counter antihistamine/vasoconstrictor sellers are powerful in treating moderate allergic conjunctivitis. Another, greater powerful, alternative is a second-technology topical histamine H1 receptor antagonist.


With the rapid growth of eye care sector in Bangladesh, a specialized hospital for the treatment of all eye related diseases was much needed. Thus Fortune Eye Hospital was founded on 18th September 2020 with the aim of providing world-class eye care service to the community at an affordable cost. Since then, we have been able to keep pace with the standards set by the international ophthalmology community in relation to outstanding patient care as well as the latest in medical advancements.

With the promise and commitment in eye care, Bangladesh Eye Hospital Ltd. is now serving from Dhanmondi.

At present Fortune Eye Hospital haveĀ  over 5 special consultants. All of whom are constantly striving to provide the best eye care service to every individual who walks through our doors. We invite you with open arms to become better acquainted with Fortune Eye Hospital and help us in our journey forwards.