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Red Eye Workup

  • Author: Robert H Graham, MD; Chief Editor: John D Sheppard, Jr, MD, MMSc  more...
 
Updated: Jan 15, 2016
 

Approach Considerations

Laboratory studies are not required for most patients. Check visual acuity, IOP, and blood pressure in every patient.

The diagnosis of scleritis and iritis generally requires further workup for associated systemic disease, including complete blood count (CBC), erythrocyte sedimentation rate (ESR), and levels of antinuclear antibody (ANA), rheumatoid factor (RF), uric acid, and rapid plasma reagin (RPR). Uncomplicated episcleritis and iritis warrant further evaluation if more than 1 episode occurs. Send exudate from patients with conjunctivitis for bacterial culture, especially in cases of corneal ulceration or significant conjunctival disease.

In the setting of potential subconjunctival hemorrhage, if there is a history of trauma, rule out a ruptured globe or retrobulbar hemorrhage.[19] If the condition is recurrent or there is a history of bleeding problems (eg, epistaxis or easy bruising), then bleeding time, prothrombin time (PT), activated partial thromboplastin time (aPTT), CBC with platelets, and protein C and S levels should be obtained, and consultation with an internist should be considered.[11]

 
 
Contributor Information and Disclosures
Author

Robert H Graham, MD Consultant, Department of Ophthalmology, Mayo Clinic, Scottsdale, Arizona

Robert H Graham, MD is a member of the following medical societies: American Academy of Ophthalmology, Arizona Ophthalmological Society, American Medical Association

Disclosure: Partner received salary from Medscape/WebMD for employment.

Coauthor(s)

Norvin Perez, MD Medical Director, Juneau Urgent and Family Care

Norvin Perez, MD is a member of the following medical societies: American College of Emergency Physicians, American Medical Association

Disclosure: Nothing to disclose.

Vivian Monsanto, MD 

Vivian Monsanto, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Ophthalmology

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Chief Editor

John D Sheppard, Jr, MD, MMSc Professor of Ophthalmology, Microbiology and Molecular Biology, Clinical Director, Thomas R Lee Center for Ocular Pharmacology, Ophthalmology Residency Research Program Director, Eastern Virginia Medical School; President, Virginia Eye Consultants

John D Sheppard, Jr, MD, MMSc is a member of the following medical societies: American Academy of Ophthalmology, American Society for Microbiology, American Society of Cataract and Refractive Surgery, Association for Research in Vision and Ophthalmology, American Uveitis Society

Disclosure: Nothing to disclose.

Acknowledgements

Gino A Farina, MD Program Director, Associate Professor of Clinical Emergency Medicine, Department of Emergency Medicine, Long Island Jewish Medical Center, Albert Einstein College of Medicine

Gino A Farina, MD is a member of the following medical societies: American Academy of Emergency Medicine, American College of Emergency Physicians, and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Judith Flaherty-Arnoux, MD Resident Physician, Department of Emergency Medicine, Long Island Jewish Medical Center

Disclosure: Nothing to disclose.

Kilbourn Gordon III, MD, FACEP Urgent Care Physician

Kilbourn Gordon III, MD, FACEP is a member of the following medical societies: American Academy of Ophthalmology and Wilderness Medical Society

Disclosure: Nothing to disclose.

Simon K Law, MD, PharmD Assistant Professor of Ophthalmology, Jules Stein Eye Institute; Chief of Section of Ophthalmology Surgical Services, Department of Veterans Affairs Healthcare Center, West Los Angeles

Simon K Law, MD, PharmD is a member of the following medical societies: American Academy of Ophthalmology, American Glaucoma Society, and Association for Research in Vision and Ophthalmology

Disclosure: Nothing to disclose.

Gregory I Mazarin, MD Assistant Professor, Department of Emergency Medicine, Department of Emergency Medicine, Montefiore Medical Center, Albert Einstein College of Medicine; Consulting Staff, St Vincent's Midtown, North Shore University Hospital

Gregory I Mazarin, MD is a member of the following medical societies: Alpha Omega Alpha

Disclosure: Nothing to disclose.

J James Rowsey, MD Former Director of Corneal Services, St Luke's Cataract and Laser Institute

J James Rowsey, MD is a member of the following medical societies: American Academy of Ophthalmology, American Association for the Advancement of Science, American Medical Association, Association for Research in Vision and Ophthalmology, Florida Medical Association, Pan-American Association of Ophthalmology, Sigma Xi, and Southern Medical Association

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

References
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Follicular conjunctivitis and subconjunctival hemorrhage.
Symblepharon secondary to epidemic keratoconjunctivitis.
Blepharitis. Courtesy of Wikipedia Commons.
Scleritis. Courtesy of Wikipedia Commons.
Acute dacryocystitis.
Canaliculitis of the left lower lid. Courtesy of Peter Rubin, MD, Director, Eye Plastics Service, Massachusetts Eye and Ear Infirmary, Harvard Medical School.
Corneal abrasion.
This photograph depicts a child with a bilateral eye condition known as interstitial keratitis (IK), a stigma related to congenital syphilis.
Conjunctivitis. Courtesy of Wikipedia Commons.
 
 
 
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