Diagnostic Considerations

The differential diagnosis is so large that the caregiver must be comfortable with all diagnoses and must be able to distinguish between them. Misdiagnosis is a major medicolegal pitfall, in that the truly emergent conditions that may cause red eye have major vision-threatening sequelae.

The occurrence of subconjunctival hemorrhage in an eye after scleral buckle indicates buckle infection until proved otherwise, even if the surgery was performed years before. Usually, there is focal tenderness somewhere over the buckle.

Conjunctival neoplasms that give rise to secondary hemorrhage must also be considered in the differential diagnosis.

Differential Diagnoses

Workup

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Media Gallery

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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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, American Medical Association, Arizona Ophthalmological Society

Disclosure: Nothing to disclose.

Coauthor(s)

Vivian R Monsanto, MD Clinical Instructor, Department of Ophthalmology, New York University Grossman School of Medicine; Ophthalmologist, NYU Langone Health

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

Disclosure: Nothing to disclose.

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.

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

Andrew A Dahl, MD, FACS Assistant Professor of Surgery (Ophthalmology), New York College of Medicine (NYCOM); Director of Residency Ophthalmology Training, The Institute for Family Health and Mid-Hudson Family Practice Residency Program; Staff Ophthalmologist, Telluride Medical Center

Andrew A Dahl, MD, FACS is a member of the following medical societies: American Academy of Ophthalmology, American College of Surgeons, American Intraocular Lens Society, American Medical Association, American Society of Cataract and Refractive Surgery, Contact Lens Association of Ophthalmologists, Medical Society of the State of New York, New York State Ophthalmological Society, Outpatient Ophthalmic Surgery 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