Red Eye Workup

Updated: Feb 25, 2022
  • Author: Robert H Graham, MD; Chief Editor: Andrew A Dahl, MD, FACS  more...
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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 one 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]