Red Eye in Adults and Older Children

Key Points

Red eye in adults and older children requires careful evaluation to differentiate the various causes of inflammation. Purulent conjunctival discharge warrants culturing and broad-spectrum antibiotics.

Allergic conjunctivitis generally responds well to topical treatment; symptoms may manifest or worsen on initiation of systemic antihistamines.

Figure 41-7 Acute hordeolum, or stye. The swollen, tender, red eyelid includes an acute, boil-like lesion. Treatment includes warm compresses and topical antibiotics. (From AAO. The Red Eye.)

• Orbital cellulitis requires prompt computed tomography and systemic antibiotics. Cultures should be obtained from the nasopharynx, conjunctiva, and blood.

• Iritis is characterized by pain, photophobia, miosis, and circumciliary injection and generally occurs after blunt trauma.

• A red eye in a contact lens wearer requires prompt evaluation for a corneal ulcer.

• Acute angle-closure glaucoma is an ocular emergency and requires immediate treatment by an ophthalmologist.

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