Peer Reviewed

Is it conjunctivitis or something more serious? Use this diagnostic tree to find out what's causing that red eye.

Checklist: Examining the Red Eye

  • Observe eye to determine what part(s) are affected, what appears normal/abnormal, whether eye is painful, and presence of discharge.
  • Develop list of diagnostic differentials based on ocular changes and conduct diagnostic testing.
  • Determine whether eye is visual.
  • Assess pupil size and light reflexes.
  • Perform STT for quantitative assessment of tear production.
  • Perform ocular surface staining:
    • Fluorescein staining to assess corneal epithelium defects, NLD patency, and tear film breakup   time and stability
    • Seidel’s test to identify leakage of aqueous humor through cornea
    • Rose bengal staining to measure precorneal tear film quality and integrity
  • Perform tonometry to estimate IOP: elevation consistent with glaucoma, decrease consistent with intraocular inflammation.
  • Complete examination and systemic diagnostic testing as indicated.

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