OP3.1 | Red Eye History Taking and Cause Framework — Summary & Reflection

KEY TAKEAWAYS

Red eye has a structured differential organised by anatomical compartment: conjunctival (conjunctivitis, subconjunctival haemorrhage), corneal (keratitis, abrasion, foreign body), uveal (anterior uveitis), scleral (scleritis), and angle-closure glaucoma. The systematic history template — onset/laterality, discharge character, pain, photophobia, vision change, trauma/contacts, systemic history — narrows the differential before the examination. The five danger signs (Pain, Photophobia, Pupil abnormality, vision Change, Corneal opacity/Ciliary flush — PPPCC) identify the sight-threatening cases requiring urgent referral. Ciliary flush (circumcorneal injection, non-blanching, violet-red) distinguishes anterior segment inflammation from benign conjunctival injection. Pinhole improvement of VA indicates refractive blur; failure to improve signals an organic cause. Acute angle-closure glaucoma — severe pain, halos, vomiting, fixed mid-dilated pupil in an elderly hypermetrope — is an ocular emergency.

REFLECT

Think about the last patient or OSCE scenario in which you encountered a red eye. Did you follow a systematic approach or did you anchor on the most common diagnosis (conjunctivitis) early? What question, if you had asked it, would have been most discriminating? If you were to teach a junior colleague the single most important thing to do in a red eye consultation, what would it be and why? Write two or three sentences in your reflective journal before your next skills laboratory.