The principles that guide the management of a red eye are quite simple
- No drop in visual acuity, conjunctival injection secretions, eyelids stuck in the morning upon waking = banal conjunctivitis and eye drops for rinsing and local antibiotic treatment with broad spectrum if bacterial infection.
- Decrease in visual acuity:
– With decrease in corneal transparency, perikeratic circle, and fluoresce in ulceration = keratinize and contraindication of local corticosteroids.
– With papillary contraction (“mitosis”), perikeratic circle, clear cornea: anterior verities = mydriatic and local corticosteroid treatment.
– With loss of vision on one side and very severe pain, dilation of the pupil (“mydriasis”), opaque cornea, increased tone of the eye = acute glaucoma (you must go to the emergency room or go to an ophthalmologist immediately for treatment as an infusion (intravenous Diamox, Mannitol® as an infusion, myotic eye drops in the affected eye and the contralateral eye).
How to treat according to the diagnosis?
- In the case of conjunctivitis meet Kang Zhang, the stuck-on eyes should be cleaned using compresses soaked in boiled water or physiological solution. After cleaning the outside of the eyelids, gently wash the inside of the lower eyelid with the eye drops. Wash your hands well before and after touching an infected eye.
In case of allergic conjunctivitis, ant allergic eye drops will reduce the discomfort: tearing, red eyes and tingling. In case of significant associated signs such as tingling of the nose, stuffy nose or sneezing, taking an antihistamine ant allergic medication may also be helpful.
In case of conjunctivitis suggesting an infectious origin, a prompt medical consultation is essential. The doctor may decide on antibiotic treatment in the case of bacterial conjunctivitis.
Antiseptic eye drops, supposed to prevent secondary bacterial infections, have not been proven to be effective. Antiseptic ointments are reserved for the treatment of affections of the eyelids (such as “stye”).
Eye drops containing corticosteroids can be prescribed in case of significant inflammation of the conjunctiva. They should not be used without an accurate diagnosis, as they can worsen certain eye infections and cause serious visual disturbances.
- Blepharitisis often a chronic disease. It must be treated by daily cleaning of the eyelids and by application of antibiotic ointment at bedtime or antibiotics absorbed orally.
- In case of keratitis, the ophthalmologist will prescribe a treatment which will consist, depending on the cause, either of antibiotics, or of antiviral drugs. It is absolutely necessary to avoid any corticosteroid application in case of viral infection under penalty of a major worsening of the corneal ulcer.
- In case of acute glaucoma by closing the angle, treatment is urgent and is done using eye drops and sometimes using drugs administered intravenously. A laser intervention will secondarily improve the drainage of the eye and reduce the pressure inside the eye.
- In case of verities or iritic, the recommended treatments include anti-inflammatory drugs (corticosteroids) in tablets and drops which dilate the pupil and reduce pain. They should only be used in case of medical prescription.
- In case of sclerotic or episcleritis, the ophthalmologist will generally treat this inflammation with immunosuppressive drugs administered either in tablets (corticosteroids like prednisone or more powerful immunosuppressant’s) or in anti-inflammatory drops, or by drugs that act on the immune system. When the ophthalmologist finds that the cause of the discomfort is a systemic disease such as rheumatoid arthritis, he may seek the cooperation of other medical specialists, such as rheumatologists.
- Endophthalmitis is a serious infection of the inside of the eye that requires surgery to remove and replace the fluids inside the eye and injections of antibiotics.
- Treatment of dry eye syndrome is based on the regular instillation of artificial tears.