Red Eye – Serious or not?

On examination, the eye is red and watering. The patient is unable to read letters from the Snellen chart but can count fingers. Her pain in the right eye is worsened when shining a pen torch directly at or near her right eye and when shining on the left eye.

What is the likeliest diagnosis?

Slit lamp examination is performed with dilated pupils in the emergency department and the posterior chamber and retina appear normal. Inflammatory markers are normal, and it is thought the patient has a non-infectious condition.

How should this patient be managed in the emergency department?

The patient mentions to you that whilst she was at work during her break, she felt something go into her other eye. She rubbed her eye vigorously to remove this sensation. Eventually the sensation lessened however, she still feels some discomfort.

You examine her eye and see no obvious foreign body. You examine using the slit lamp and fluorescein dye which reveals that the patient has a 40% corneal abrasion. On dilation of the pupils no retinal damage is noted.

How should the patient’s left eye be managed?