Atraumatic Red Eye

Author: Jonathan D Whittaker / Editor: Tajek Hassan / Reviewer: Louise Burrows, Kathryn Blackmore / Code: O8 / Published: 09/10/2023

The red eye is a common presenting complaint to the Emergency Department (ED). This session will help you to become familiar with all the different causes of a red eye and how to differentiate between them.

After completing this session you will be able to:

  • Identify the clinical features of the different types of conjunctivitis and describe appropriate investigation and management
  • Differentiate clinically between inflammatory conditions of the anterior uveal tract and give examples of the aetiological associations
  • Distinguish episcleritis from scleritis and formulate a management plan for both conditions
  • Recognise the clinical features of acute open angle glaucoma and describe an initial management plan

Before completing this session you should complete the following sessions:


  1. Dart JK. Eye disease at a community health centre. Br Med J (Clin Res Ed). 1986 Dec 6;293(6560):1477-80.
  2. McDonnell PJ. How do general practitioners manage eye disease in the community? Br J Ophthalmol. 1988 Oct;72(10):733-6.
  3. Mahmood AR, Narang AT. Diagnosis and management of the acute red eye. Emerg Med Clin North Am. 2008 Feb;26(1):35-55, vi.
  4. Tripathi RC, Tripathi BJ, Haggerty C. Drug-induced glaucomas: mechanism and management. Drug Saf. 2003;26(11):749-67.
  5. Rietveld R P, Riet G t, et al. Predicting bacterial cause in infectious conjunctivitis: cohort study on informativeness of combinations of signs and symptoms. BMJ 2004; 329 :206.
  6. Patel PB, Diaz MC, Bennett JE, Attia MW. Clinical features of bacterial conjunctivitis in children. Acad Emerg Med. 2007 Jan;14(1):1-5.
  7. Rose PW, Harnden A, Brueggemann AB, et al. Chloramphenicol treatment for acute infective conjunctivitis in children in primary care: a randomised double-blind placebo-controlled trial. Lancet. 2005 Jul 2-8;366(9479):37-43.
  8. Rietveld RP, van Weert HC, et al. Diagnostic impact of signs and symptoms in acute infectious conjunctivitis: systematic literature search. BMJ. 2003 Oct 4;327(7418):789.
  9. Sheikh A, Hurwitz B, van Schayck CP, McLean S, Nurmatov U. Antibiotics versus placebo for acute bacterial conjunctivitis. Cochrane Database Syst Rev. 2012 Sep 12;(9):CD001211.
  10. Hvding G. Acute bacterial conjunctivitis. Acta Ophthalmol. 2008 Feb;86(1):5-17.
  11. Bourcier T, Thomas F, et al. Bacterial keratitis: predisposing factors, clinical and microbiological review of 300 cases. Br J Ophthalmol. 2003 Jul;87(7):834-8.
  12. Gordon-Bennett P, Ung T, et al. Misdiagnosis of angle closure glaucoma. BMJ. 2006 Dec 2;333(7579):1157-8.
  13. Jabs DA, Mudun A, Dunn JP, Marsh MJ. Episcleritis and scleritis: clinical features and treatment results. Am J Ophthalmol. 2000 Oct;130(4):469-76.
  14. Okhravi N, et al. Scleritis. Surv Ophthalmol. 2005 Jul-Aug;50(4):351-63.
  15. Huhtinen M, Karma A. HLA-B27 typing in the categorisation of uveitis in a HLA-B27 rich population. Br J Ophthalmol. 2000 Apr;84(4):413-6.
  16. Hunsley T, Lee C. Does a normal shaped pupil exclude the diagnosis of iritis. BestBets, 2006.

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