Urgent Care Evaluation and Management of the Red Eye (Infectious Disease and Pharmacology CME)

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Delivery Method:	Online
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Publication Date: August 2023 (Volume 2, Number 8)

CME Credits: 4 AMA PRA Category 1 Credits™. CME expires 08/01/2026.

Specialty CME: Included as part of the 4 credits, this CME activity is eligible for 1 Infectious Disease and .25 Pharmacology CME credits, subject to your state and institutional requirements.

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Author

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Charting & Coding Author

Abstract

Red eyes are a common presenting complaint in urgent care settings, with causes that range from benign to vision-threatening. A thorough and efficient evaluation of red eyes is critical to identify more serious causes and provide prompt referral if needed. A detailed patient history and eye examination, along with the use of diagnostic tools such as visual acuity testing and fluorescein staining, will guide the urgent care clinician in the assessment. This review provides an evidence-based framework for evaluating red eye presentations in urgent care. Recommendations for management are also offered, including indications for consultation or emergent referral to ophthalmology, along with treatment recommendations for conditions that can be managed in urgent care.

Case Presentations

A 23-year-old woman presents with 1 month of mild eye redness and itchiness...

• She has minimal clear discharge involving both eyes that is consistent throughout the day.
• She reports no systemic symptoms other than seasonal allergies.
• The patient says she just needs antibiotic drops for her “pink eye,” but you suspect a different etiology...

A 35-year-old man presents with 48 hours of redness in his left eye...

• He complains of increased tear production and increasing discomfort in the eye.
• He is photophobic to minimal light.
• His pupils are equal in size. On penlight exam, you notice there is significant limbic injection.
• You wonder what additional diagnostic steps should be taken for this patient...

A 69-year-old man presents with acute onset of visual loss and redness in his right eye...

• He complains of discomfort, vision loss, and redness without discharge in the right eye. His left eye is unaffected.
• Symptoms began after he lifted a heavy suitcase into the trunk of his car. He was able to drive home from his vacation, but when his vision did not improve after the drive, he decided to come to the urgent care clinic.
• As part of your focused history, you learn that the patient had lens replacement surgery 3 months ago for cataracts.
• Given the recent eye surgery, you know that an ophthalmology referral will be needed. As you proceed with the eye examination, you consider how urgent that referral will need to be...

Accreditation:

EB Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.