Posted on January 13 2014
Taken from November issue of EyeMed
More and more frequently, acute red eye is treated at the front line by general practice ophthalmologists, pediatric ophthalmologists and optometrists because ophthalmic specialists are relied on more for surgical care.
Defining red eye
To understand the confusion associated with the differential diagnosis of an acute red eye, it is important to define it. Red eye can present in the form of dry eye, allergic, bacterial or viral conjunctivitis, or blepharitis. Symptoms of dry eye may include decreased tear production and increased tear evaporation. Under the diagnostic tree of allergic conjunctivitis, symptoms include a bilateral presentation, conjunctival edema and/or hyperemia, chemosis, lid edema, watery discharge, ocular itching, burning, tearing, photophobia, foreign body sensation and blurred vision. Under the diagnostic tree of bacterial conjunctivitis, a patient may present with unilateral or bilateral acute onset, pain, marked lid edema, a large amount of purulent discharge, marked conjunctival hyperemia and possible membrane formation. Patients with blepharitis may experience redness, irritation, burning, tearing, itching, crusting of the eyelashes and many other symptoms.
Different seasons bring different types of acute red eye, so around April or September in the Carolinas, when everything is coated in yellow pollen or ragweed is at a peak level, we are more likely to see allergic conjunctivitis. At the start of the school year, we are more likely to see bacterial conjunctivitis, which is not seen as frequently and is more popular in Southern and humid states. Because it is not common, it has been difficult to distinguish.
Treating red eye
If a person walks into my practice complaining of a red eye and has a draining, infectious-looking eye, he or she is seen right away. My assistants are trained to screen patients at the door. Once my staff suspects that a patient may have a contagious infection, they immediately sequester the patient in a no-traffic room that can eventually be shut down and cleaned. This is extremely important because an epidemic can occur in a clinic in no time. If an infectious person is moved from room to room, he or she may expose up to three or four different work areas.
Early diagnoses with the Red Eye Protocol and adoption of this potential treatment have enabled me to make a rapid, accurate diagnosis for acute red eye and prevent both the spread of infection and antibiotic resistance.