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Red eye in general practice

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

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  • 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 containing borax or boric acid buffers (boron): use in children younger than 2 years (2)

  • following a review of the available toxicological data and a calculation of daily exposure to boron from a typical dosing regimen, it was concluded that the balance between the benefits and risks of chloramphenicol eye drops containing borax or boric acid remains positive for children aged 0 to 2 years
  • chloramphenicol eye drops can be safely administered to children aged 0 to 2 years where antibiotic eye drop treatment is indicated

Reference:

  1. Drug Safety Update volume 14, issue 12: July 2021: 1.Chloramphenicol eye drops containing borax or boric acid buffers: use in children younger than 2 years

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The content herein is provided for informational purposes and does not replace the need to apply professional clinical judgement when diagnosing or treating any medical condition. A licensed medical practitioner should be consulted for diagnosis and treatment of any and all medical conditions.

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