red eye in general practice

Last edited 03/2021 and last reviewed 03/2021

  • 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