The Red Eye

Abstract

The majority of recently-qualified practitioners approach the red eye with considerable trepidation, presumably because ophthalmology occupied a small part of their training, or, more likely, that it was improbable that an `eye case' would feature in the written or clinical parts of their final examination and so could be ignored with a high degree of safety-for the student, if not for subsequent patients. Once qualified, there seems to be a marked reluctance on the part of most practitioners to close this gap in their medical knowledge. Here in Zambia it is safe to say that nearly every person develops ocular pathology at some time in his life, and I do not include errors of refraction in the category of pathology. The diagnosis of the red eye is made more difficult for the practitioner by the fact that seldom is any attempt made to take a proper history, and even less attempt to record the eye's function, i.e. to record the visual acuity. Even such basic factors as to whether the pathology was spontaneous or the result of trauma and the duration of the complaint are usually omitted. Any previous ophthalmic history, including surgery, is only recorded if the patient vouchsafes the information. I hope that no practitioner would refer a patient to a consultant surgeon with the entire contribution towards a diagnosis being "abdominal pain" or to a consultant physician with "coughing" but it is extremely common to find a patient referred to a consultant ophthalmologist with "sore eyes" "poor sight" or "bad eyes" as the total sum of symptoms and signs. It is to help the general duties Medical Officers, especially those far distant from consultant help that the following article has been prepared. Trauma as will be appreciated this covers an enormous field in ocular pathology and is extremely common. Such trauma may be from physical contact or instrumental injury such as is seen so frequently with beer hall fights, car, industrial and other accidents, burns, caustic and chemical injuries (including cobra-venom), thermal as with eclipse scotoma and abiotic as with `arc eyes'. Many of these require specialist attention, but the following are listed as frequent and/or important