Differential Diagnosis

The differential diagnosis of the "red (or pink) eye" includes conjunctivitis, orbital/periorbital infection, foreign body, corneal abrasion, uveitis, and glaucoma. Periorbital and orbital infections cause obvious swelling and tenderness around the eye and/or loss of ocular mobility. Foreign bodies should be visible on direct examination, often only following eversion of the upper eyelid. Thus the differential diagnosis usually revolves around four conditions: conjunctivitis, corneal abrasion, uveitis, and glaucoma (Table HZ-2). Both uveitis and glaucoma are uncommon. The erythema in these conditions is concentrated around the limbus, and the discharge consists primarily of tears. Additionally, the vision is decreased in glaucoma, and the cornea may be cloudy. A corneal abrasion is easily identified by the uptake of fluorescein.

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TABLE 117-2 Differential Diagnosis of the "Red Eye"

TABLE 117-2 Differential Diagnosis of the "Red Eye"

Finally, conjunctivitis may be only one manifestation of a systemic disorder, such as measles and Kawasaki disease. Complications

Conjunctivitis is generally self-limited, with the notable exceptions of herpes simplex and N. gonorrhoeae. The potential complications are corneal ulceration and scar formation leading to visual impairment.

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