Granet David
University of California-San Diego/Ratner Children's Eye Center, La Jolla, CA 92037, USA.
Allergy Asthma Proc. 2008 Nov-Dec;29(6):565-74. doi: 10.2500/aap.2008.29.3170.
Red eye is a common presentation in clinical practice with conjunctivitis being the most common cause of red eye. Most commonly, conjunctivitis is infective (bacterial and viral) or allergic in origin although other forms of conjunctivitis including toxic and irritative conjunctivitis and conjunctivitis related to systemic conditions or dry eye are prevalent enough to warrant consideration in diagnosis. This article aims to provide a guide for generalists and allergists in the differential diagnosis of conjunctivitis allowing the inclusion of eye treatment into their current practice. With a discussion of important aspects to include in the patient history as well as a systematic guide to examination of the eye for generalists and allergists, this article provides a "plan of action" in the examination protocol for red eye patients. A differential diagnosis table and flowchart are provided as a useful chair-side reference for practitioners. With a particular focus on the more prevalent types of conjunctivitis, typical features, signs, and symptoms of each type are detailed. A general discussion of prognosis and treatment options and conditions that require ophthalmologic referral is included.
红眼是临床实践中的常见症状,结膜炎是导致红眼最常见的原因。最常见的情况是,结膜炎的病因是感染性的(细菌性和病毒性)或过敏性的,不过其他形式的结膜炎,包括中毒性和刺激性结膜炎以及与全身疾病或干眼相关的结膜炎,也较为普遍,足以在诊断时加以考虑。本文旨在为全科医生和过敏症专科医生提供一份结膜炎鉴别诊断指南,以便他们将眼部治疗纳入当前的诊疗工作中。通过讨论患者病史中应包含的重要方面,以及为全科医生和过敏症专科医生提供的眼部检查系统指南,本文为红眼患者的检查方案提供了一个“行动计划”。文中提供了一个鉴别诊断表和流程图,作为从业者方便的床边参考资料。特别关注更常见的结膜炎类型,详细介绍了每种类型的典型特征、体征和症状。还包括对预后、治疗选择以及需要眼科转诊的情况的一般性讨论。