The pupil must be examined for size, shape and reaction to light. A mid-size, unreactive pupil is a classic sign of acute angle closure glaucoma.
An irregular or oval pupil is a sign of anterior uveitis or previous ophthalmic surgery (see image, right).
All patients should have fluorescein instilled into the eye to look for epithelial defects. Examination with a slit lamp will enable the clinician to identify small corneal lesions or flare and inflammatory cells in the anterior chamber, typically found in anterior uveitis.
If facilities exist, the intraocular pressure should be measured if acute angle closure glaucoma is suspected.
Finally, a general examination of the patient may be required for signs of systemic features associated with some causes of the red eye e.g. inflammatory joint and bowel disorders.