History of Present Illness

A man in his early 30s with no medical history of significance presents to the emergency department (ED) for evaluation of a painful red eye that has been present for the past 10 days. The patient does not wear contact lenses and denies any discharge or change in vision related to the right eye pain. He states that he has had pink eye before but that it usually resolves more quickly and is not as painful. The patient’s left eye is unaffected.

Vital Signs and Physical Examination

The patient’s vital signs are normal. Physical examination is normal except for the right eye, which is red (Figure).  Evaluation of the conjunctiva, eyelids, sclera, cornea, pupil, anterior chamber, and anterior uvea is performed. A trial of a topical anesthetic in the ED provided no pain relief.

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