red eye in general practice
Last edited 03/2021 and last reviewed 05/2021
- conjunctivitis, dry eyes and foreign bodies are the common causes of red eyes in general practice
- treat as an emergency anything you don't come across regularly including iritis, acute glaucoma and ophthalmic herpes. Ophthalmology is a vast subject and delay can quickly lead to a blind eye
- steroids must be avoided unless you are absolutely sure the eye is not infected such as in recurring iritis
- be suspicious of a unilateral red eye - infective conjunctivitis is usually bilateral by the time it presents
- itching is nearly always allergy - Cromoglycate (aqueous) is safe and works well but Nedocromil needs to be used less often
- to instil eyedrops, pull down lower lid especially in children: the lid is much less sensitive than the eyeball
- Chloramphenicol causes aplastic anaemia so extremely rarely
- can cause allergic blepharitis in chronic use
- chloramphenicol eye drops must not be given to a child less than 2 years old as it contains boron and may impair fertility in the future
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