Materiały źródłowe

• #1 Red Eye: Background, Pathophysiology and Etiology, Epidemiology and Prognosis

  https://emedicine.medscape.com/article/1192122-overview

  A red eye most often results from dilation of blood vessels in the anterior portion of the eye. […] Diagnosis may be aided by the differentiation between ciliary and conjunctival injection. Ciliary injection involves branches of the anterior ciliary arteries and indicates inflammation of the cornea, iris, or ciliary body. […] Conjunctivitis, the most common cause of red eye, is characterized by vascular dilation of the superficial conjunctival blood vessels, cellular infiltration, and exudation; it must be differentiated on the basis of etiology (viral, bacterial, or allergic). […] The episclera is the layer between the conjunctiva and the sclera. Episcleritis is an inflammation of the episcleral vessels, usually of autoimmune origin; it can be caused by virtually any inflammatory systemic condition affecting the body, such as rheumatoid arthritis, Sjgren syndrome, coccidioidomycosis, syphilis, zoster, or tuberculosis.

• #1 Red Eye: Causes, Treatment & Prevention

  https://my.clevelandclinic.org/health/symptoms/17690-red-eye

  A red eye is a general term to describe red, irritated and bloodshot eyes. The redness happens when tiny blood vessels under your eyes surface get larger or become inflamed. […] If your eye becomes red from an injury, the blood vessels in your eye dilate (open) to allow more blood to get to the site for quicker healing. These wide-open blood vessels are what cause the red eye. […] In many cases, red eyes aren’t dangerous and may not even need treatment. However, there are conditions that cause red eyes that can be more serious. […] If your red eye is a sign that you have a more serious condition than just irritation, not treating it could lead to vision loss. […] Although red eye usually goes away on its own, redness of the eye can sometimes signal a more serious eye condition or disease.

• #1

  https://www.vin.com/apputil/content/defaultadv1.aspx?id=5709773&pid=11372

  Ocular surface hyperaemia (so-called „red-eye”) is one of the most common and potentially one of the most critical reasons animals are presented for ocular disease. […] The goal of this session is to heighten awareness of the differential diagnoses that may cause ocular hyperaemia and to define simple clinical methods to differentiate these. […] In addition to physiologic vasodilation due to hyperthermia, there are (at a mechanistic level) two common ways a blood vessel becomes hyperaemic or „injected.” […] The release of vasoactive mediators at a specific site acts locally to cause (among other things) dilation of the blood vessels that supply that site. […] Blood vessels terminating (in the case of arterioles) or originating (in the case of venules) in the conjunctiva and uvea share a common pathway through the orbit to and from the major vessels of the head and neck.

• #1 Ocular Redness – I: Etiology, Pathogenesis, and Assessment of Conjunctival Hyperemia

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8328962/

  The vasodilatation of conjunctival microvessels is clinically reported as hyperemia (or redness), plays a critical role in the efferent component of the immune system, delivering both humoral and cellular immune components to the site of inflammation. The inflammatory process in the conjunctival tissue is mediated by physiologically active molecules such as histamine, cytokines, and associated neuropeptides. […] Histamine is an endogenous organic nitrogenous compound that plays a critical role in localized immune responses and is released predominantly from mast cell granules and in lesser quantities by basophils and neutrophils. In normal conjunctiva, approximately 5,0006,000 mast cells/mm3 are found below the basement membrane in the substantia propria and contain approximately 4.6 pg/cell of histamine. The proteases released by the allergens activate protease-activated receptor-2 in the conjunctival tissue which leads to the breakdown of the tight junctions between conjunctival epithelial cells and enter the subepithelial layer.

• #1 Red Eye Roundup

  https://www.reviewofoptometry.com/article/red-eye-roundup

  The eye appears red due to blood vessel dilation. Ciliary injection, which results from dilation of anterior ciliary artery branches, implies inflammation of the cornea, iris or ciliary body. […] Conjunctival injection, however, is due to dilation of the more posterior and superficial conjunctival vessels, which causes a more dramatic injection. […] Clinical acumen determines the next course of action. Following red eye algorithms plenty of which exist may be beneficial. […] Uveitis should always be among the top differentials in a patient presenting with acute conjunctival hyperemia. Injection is characteristically circumlimbal and engorged variably with cells and flare in the anterior chamber. […] Topical corticosteroids are the mainstay of anterior uveitis treatment. The instillation interval depends on disease severity, and aggressive early therapy is common practice.

• #1 Clinical Approach to the Canine Red Eye | Today’s Veterinary Practice

  https://todaysveterinarypractice.com/ophthalmology/clinical-approach-to-the-canine-red-eye/

  The acute red eye is a common clinical challenge for general practitioners. Redness is the hallmark of ocular inflammation but a nonspecific sign related to a number of underlying diseases. Proper evaluation depends on effective and efficient diagnosis in order to save the eye’s vision and the eye itself. […] Proper evaluation of the red eye depends on effective and efficient diagnosis of the underlying ocular disease in order to save the eye’s vision and the eye itself. […] The conjunctiva has small, fine, tortuous and movable vessels that help distinguish conjunctival inflammation from deeper inflammation. […] Corneal ulcers result in corneal vascularization, which appears as a “red eye.” […] Corneal blood vessels are an indication of chronic disease and, generally, take 1 to 3 days to proliferate on the corneal surface.

• #1 Atraumatic Red Eye – RCEMLearning

  https://www.rcemlearning.co.uk/reference/atraumatic-red-eye/

  The red eye is a term used to describe the reaction of the eye to exogenous or endogenous inflammation or infection. It encompass inflammatory processes originating in the conjunctiva, episclera, sclera and anterior uveal tract. […] Aqueous humour, produced by the ciliary body in the posterior chamber, flows into the anterior chamber through the narrow gap between the iris and lens. It is absorbed through the trabecular meshwork into a venous sinus known as the canal of Schlemm. Intraocular pressure is maintained by a constant cycle of production and absorption of aqueous humour. Obstruction of aqueous humour flow by closure of the gap between the lens and iris and/or blockage of the trabecular meshwork raises intraocular pressure and, in the acute situation, may precipitate acute angle closure glaucoma.

• #1 Managing Contact Lens-associated Red Eye

  https://www.reviewofcontactlenses.com/article/managing-contact-lensassociated-red-eye

  Many ODs have seen patients present with contact lens-associated red eye (CLARE), an inflammatory response to overnight lens wear that involves the cornea and conjunctiva.1 While often easy to treat, it requires ongoing patient education to avoid recurrence. […] CLARE is thought to occur in conditions under hypoxic stress and in the presence of gram-negative bacteria that colonize contact lens surfaces, stimulating an inflammatory event of the cornea and conjunctiva, secondary to the release of bacterial endotoxins.8-11 […] There are several risk factors for CLARE, including extended contact lens wear, tight-fitting lenses, high water lenses, replacement noncompliance, improper contact lens solution use, poor contact lens hygiene and a history of upper respiratory tract infection.9,10,12

• #1

  https://www.healio.com/news/ophthalmology/20120620/woman-complains-of-red-eye-irritation

  A 51-year-old woman was referred to the cornea service complaining of a red and irritated right eye for 2 days. […] Peripheral ulcerative keratitis (PUK) is characterized by destructive inflammation of the peripheral cornea leading to sloughing of the corneal epithelium and keratolysis (corneal melt). Local or systemic autoimmune diseases cause a majority of these cases. […] Most importantly, PUK may be the initial presenting feature of potentially lethal systemic vasculitis in up to 25% of patients; therefore, the ophthalmologist should order appropriate serologic testing for every patient. […] While the pathogenesis of PUK is not completely understood, circulating immune complex deposition, autoimmune reactions to corneal antigens, and hypersensitivity to exogenous antigens have been proposed to be involved in this humoral immune response.

• #1 thyroid-eye-disease-resources

  https://www.tedimpact.com/thyroid-eye-disease-pathophysiology

  IGF-1R activation on orbital fibroblasts is a cause of the progression. […] Pathogenic orbital fibroblasts are believed to recruit fibrocytes and lymphocytes that infiltrate the orbit. […] Fibrocytes differentiate into orbital fibroblasts, which enhance T-cell proliferation and activation. […] T-cells and B-cells activate orbital fibroblasts and secrete cytokines, thyroid-stimulating hormone receptor, or TSHR, autoantibodies, and insulin-like growth factor-1 receptor, or IGF-1R, autoantibodies, which contribute to the inflammatory cascade. […] Two co-localized receptors reside on the surface of orbital fibroblasts: TSHR and IGF-1R, a gatekeeper of orbital fibroblast activation. […] Autoantibodies activate TSHR and IGF-1R, and cross talk mediated by beta-arrestin creates a receptor-signaling complex that stimulates orbital fibroblasts.

• #1 Behind the mechanism of action of brimonidine tartrate ophthalmic solution

  https://www.ophthalmologytimes.com/view/behind-the-mechanism-of-action-of-brimonidine-tartrate-ophthalmic-solution

  Brimonidine selectively targets alpha two receptors. […] This distinction is crucial, as it minimizes potential side effects and reduces the risk of rebound redness, a common problem with conventional products. […] One of the standout findings from Toyos study is that the occurrence of rebound redness with Lumify was extremely low, with only nine reported cases among the large sample size. […] The study reported an almost negligible rate of ineffectiveness, underscoring Lumifys safety profile. […] Toyos also addressed the impact of brimonidine on the ocular surface. […] This innovative approach offers a promising solution for patients seeking relief from redness while maintaining the health of their ocular surface.

• #1 Red Eye: A Guide for Non-specialists

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5443986/

  Red eye can arise as a manifestation of many different systemic and ophthalmological diseases. […] The duration and laterality of red eye and the presence and severity of pain are the cornerstones of diagnosis. […] The typical signs are red eye and eyelids stuck together on waking. […] The many different possible causes of conjunctivitis are divided into infectious and non-infectious factors. […] In both conjunctivitis and keratoconjunctivitis there is an inflammatory process of the ocular surface with widening of blood vessels (conjunctival injection), cellular infiltration, and watery, slimy, or purulent exudation. […] While episcleritis is generally triggered by exogenous factors, an underlying systemic disease can be demonstrated in up to 50% of patients with scleritis. […] Iritis is the most frequently occurring form of uveitis.

• #1 Virtual consultation for red eye | The BMJ

  https://www.bmj.com/content/373/bmj.n1490

  Virtual consultation, when performed in a systematic fashion, is a safe alternative to face-to-face examination to diagnose and manage patients with acute red eye(s) […] Red eye is a common ophthalmic presentation in primary care, accounting for 2 to 3% of the consultations. […] Performing ocular examination remotely can be challenging. Adaptation with specific instructions to the patient and/or family member will be required. […] Painful red eye usually points towards more serious causes such as corneal infection, anterior uveitis, acute angle-closure glaucoma, or scleritis. […] Loss of vision in red eye suggests a more serious cause, particularly when the loss of vision is sudden, severe, or progressive. […] A painful red eye in contact lens wearers should raise the suspicion of contact lens-related corneal infection.

• #1 Red Eye – Eye Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/eye-disorders/symptoms-of-ophthalmic-disorders/red-eye

  Dilation of superficial ocular vessels can result from […] Several ocular components may be involved, most commonly the conjunctiva, but also the uveal tract, episclera, and sclera. […] Conjunctival disorders and episcleritis are differentiated from other causes of red eye by the absence of pain, photophobia, and corneal staining. Among these disorders, episcleritis is differentiated by its focality, and subconjunctival hemorrhage is usually differentiated by the absence of lacrimation, itching, and photosensitivity. Clinical criteria do not accurately differentiate viral from bacterial conjunctivitis. […] Corneal disorders are differentiated from other causes of red eye (and usually from each other) by fluorescein staining. These disorders also tend to be characterized by pain and photophobia. If instillation of an ocular anesthetic drop (eg, proparacaine), which is done before tonometry and ideally before fluorescein instillation, completely relieves pain, the cause is probably limited to the cornea. If pain is present and is not relieved by an ocular anesthetic, the cause may be anterior uveitis, glaucoma, or scleritis.

• #1 Acute red eye and back pain as a presentation for systemic illness: case report | BMC Ophthalmology | Full Text

  https://bmcophthalmol.biomedcentral.com/articles/10.1186/1471-2415-6-31

  Acute red eye is a common presentation in both primary and secondary care. Presentation in combination with other systemic symptoms can indicate serious underlying pathology. […] This case emphasises the need for consideration of systemic illness as a cause for red eye, especially in combination with other symptoms. […] The presentation of an acute red eye with systemic symptoms, particularly new onset back pain, can indicate a serious underlying medical condition. […] If systemic illness is suspected in combination with acute red eye, referral to ophthalmology should be sought. […] If endogenous endophthalmitis is diagnosed then a source of sepsis should be investigated as comprehensively as possible.

• #1 When a Red Eye is More than Meets the Eye:a Teaching Case Report on the Public Health Roleof the Eyecare Provider | The Journal of Optometric Education

  https://journal.opted.org/article/when-a-red-eye-is-more-than-meets-the-eyea-teaching-case-report-on-the-public-health-role-of-the-eyecare-provider/

  Cases of red eye can be challenging due to the numerous potential etiologies and systemic associations. […] A working diagnosis of anterior uveitis with corneal edema and increased intraocular pressure (IOP) OD without known etiology was determined. […] Further investigation of the new systemic symptoms, patient physical and ocular presentation revealed a likely diagnosis of mumps-related endotheliitis with associated trabeculitis. […] The pathology of endotheliitis is endothelial viral proliferation resulting in an inflammatory response. […] The role of ACAID results in a relatively reduced inflammatory response despite the direct infection of ocular tissue due to the suppression of a delayed hypersensitivity reaction. […] However, the reduced cell-mediated immunity to viral particles shed into the anterior chamber allows for viral proliferation in the corneal endothelium leading to the presentation of endotheliitis.

• #2 Diagnosis and Management of Red Eye in Primary Care | AAFP

  https://www.aafp.org/pubs/afp/issues/2010/0115/p137.html?ref=1b3p6k

  Red eye is the cardinal sign of ocular inflammation. The condition is usually benign and can be managed by primary care physicians. Conjunctivitis is the most common cause of red eye. Other common causes include blepharitis, corneal abrasion, foreign body, subconjunctival hemorrhage, keratitis, iritis, glaucoma, chemical burn, and scleritis. Signs and symptoms of red eye include eye discharge, redness, pain, photophobia, itching, and visual changes. […] The cause of red eye can be diagnosed through a detailed patient history and careful eye examination, and treatment is based on the underlying etiology. Recognizing the need for emergent referral to an ophthalmologist is key in the primary care management of red eye. Referral is necessary when severe pain is not relieved with topical anesthetics; topical steroids are needed; or the patient has vision loss, copious purulent discharge, corneal involvement, traumatic eye injury, recent ocular surgery, distorted pupil, herpes infection, or recurrent infections.

• #2

  https://www.vin.com/apputil/content/defaultadv1.aspx?id=5709773&pid=11372

  Therefore, orbital disease can cause enlargement („injection”) of deep and/or superficial ocular vessels via hydrostatic pressure (decreased venous return) and via local inflammatory effects on these vessels en route to and from the eye. […] Conjunctival vessels are superficial, small (fine), branch frequently, and move easily with gentle pressure from a cotton-tipped applicator or by lateral motion of the upper eyelid, extend to the limbus, and blanch within seconds after application of 1 drop of a topical vasoconstrictor such as dilute (1%) phenylephrine. […] Since superficial vessels indicate superficial disease and deep vessels indicate deeper disease, it is possible to compile a list of potential likely causes of red eye in association with deep or superficial vascular injection. […] The following is a brief outline of the diagnostic tests that should be considered for all cases of reddened eye. […] Aqueous flare occurs as a result of breakdown of the blood-ocular barrier with subsequent leakage of proteins into the anterior chamber. […] Application of fluorescein dye to the cornea should be routinely used in all reddened eyes to diagnose corneal ulcers.

• #2 Ocular Redness – I: Etiology, Pathogenesis, and Assessment of Conjunctival Hyperemia

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8328962/

  The conjunctival vasculature generates a robust response against the pathogenic invasion of the tissue despite the biological defense responses mounted by the components of the tear fluid. The resultant inflammation leads to the dilation and permeabilization of conjunctival microvessels, leading to exacerbation of inflammation and hyperemia. Pathogen-associated lipopolysaccharide (LPS) generates tumor necrosis factor-(TNF), IL-1, and IL-6 under the regulation of nuclear factor-B (NF-B). The vascular endothelial and smooth muscle cells have been shown to have TNF- and IL-1 receptors. These cytokines induce the expression of several vasodilatory mediators, including PGI2, PGE2, and nitric oxide (NO).

• #2 Red Eye Roundup

  https://www.reviewofoptometry.com/article/red-eye-roundup

  The eye appears red due to blood vessel dilation. Ciliary injection, which results from dilation of anterior ciliary artery branches, implies inflammation of the cornea, iris or ciliary body. […] Conjunctival injection, however, is due to dilation of the more posterior and superficial conjunctival vessels, which causes a more dramatic injection. […] Clinical acumen determines the next course of action. Following red eye algorithms plenty of which exist may be beneficial. […] Uveitis should always be among the top differentials in a patient presenting with acute conjunctival hyperemia. Injection is characteristically circumlimbal and engorged variably with cells and flare in the anterior chamber. […] Topical corticosteroids are the mainstay of anterior uveitis treatment. The instillation interval depends on disease severity, and aggressive early therapy is common practice.

• #2 Diagnosis and Management of Red Eye in Primary Care | AAFP

  https://www.aafp.org/pubs/afp/issues/2010/0115/p137.html?ref=1b3p6k

  Inflammation of almost any part of the eye, including the lacrimal glands and eyelids, or faulty tear film can lead to red eye. Primary care physicians often effectively manage red eye, although knowing when to refer patients to an ophthalmologist is crucial. […] Causes of conjunctivitis may be infectious (e.g., viral, bacterial, chlamydial) or noninfectious (e.g., allergies, irritants). Most cases of viral and bacterial conjunctivitis are self-limiting. […] A thorough patient history and eye examination may provide clues to the etiology of red eye. The history should include questions about unilateral or bilateral eye involvement, duration of symptoms, type and amount of discharge, visual changes, severity of pain, photophobia, previous treatments, presence of allergies or systemic disease, and the use of contact lenses. […] Chlamydial conjunctivitis should be suspected in sexually active patients who have typical signs and symptoms and do not respond to standard antibacterial treatment.

• #2 Red Eye: Background, Pathophysiology and Etiology, Epidemiology and Prognosis

  https://emedicine.medscape.com/article/1192122-overview

  Iritis is an inflammation of the anterior uveal tract. In most cases, the cause cannot be determined. Like episcleritis, however, iritis can be caused by any systemic inflammatory disease. […] Keratitis is an inflammation of the cornea and can be of bacterial, viral, fungal, or parasitic origin. […] Associated systemic disease (eg, rheumatoid arthritis, herpes zoster ophthalmicus, or gout) is found in 40% of all patients with scleritis (anterior). […] Subconjunctival hemorrhage results from bleeding of the conjunctival or episcleral blood vessels into the subconjunctival space. […] The classic presentation involves a patient without eye pain or visual disturbance who discovers the red eye in the mirror or from a concerned friend or family member. […] Bacterial pathogens in keratitis and corneal ulcers include Pseudomonas aeruginosa, S aureus, Streptococcus pneumoniae, and coagulase-negative Staphylococcus. Viral pathogens include herpes simplex and adenovirus.

• #2 Atraumatic Red Eye – RCEMLearning

  https://www.rcemlearning.co.uk/reference/atraumatic-red-eye/

  Anterior uveitis may be a primary or secondary disorder. It is strongly associated in 70% of cases with the HLA-B27 serotype. Although sometimes occurring in eye disorders such as herpetic keratitis and following recent intraocular surgery, it is more commonly associated with diseases such as sarcoidosis, ankylosing spondylitis and inflammatory bowel disease. […] Scleritis is an inflammatory process involving the deep episcleral plexus and in 30-50% of cases is associated with an underlying rheumatological disorder. Rheumatoid arthritis and Wegeners granulomatosis are the most common connective tissue and vasculitic causes. […] Acute angle closure glaucoma may present with a predominance of extraocular symptoms which may result in the diagnosis being missed. […] It is vital to differentiate between episcleritis and scleritis which may present to the ED in similar ways but which have very different clinical outcomes. […] Inflammatory cells, flare and keratitic precipitates in the anterior chamber are diagnostic features of anterior uveitis and are best seen on slit lamp examination of the eye.

• #2 Red Eye: A Guide for Non-specialists

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5443986/

  The cardinal symptoms of iritis are photophobia, ciliary injection, and absence of the secretion typical of primary conjunctivitis. […] Acute angle-closure glaucoma is an acute ophthalmological emergency most often caused by pupillary block. […] The peripheral iris becomes attached to the cornea, leading to displacement of aqueous humor outflow with a resulting marked increase in internal ocular pressure.

• #2

  https://journals.lww.com/ijo/fulltext/1996/44010/gram_negative_bacteria_and_contact_lens_induced.6.aspx

  Two patients using hydrogel contact lenses on a daily wear schedule slept overnight with the lenses and woke up with a Contact Lens Induced Acute Red Eye (CLARE). […] Evidence also suggests that an increased number of these complications are seen with hydrogel lenses used on an extended wear schedule. Some of these conditions include inflammatory responses such as Contact Lens Induced Acute Red Eye (CLARE), and Culture Negative peripheral Ulcers (CNPU) and sight threatening responses such as infectious keratitis. […] While the aetiology of a CLARE response is not clearly understood, it is seen that the condition is distinct and typically presents with the patient waking in the early hours with discomfort and pain in the involved eye. […] Recent studies reported that patients experiencing CLARE may form a group of contact lens wearers who repeatedly show high levels of gram negative bacterial contamination of their contact lenses. The release of endotoxin from the breakdown of the cell wall of these bacteria was considered to trigger off the inflammatory response.

• #2 Managing Contact Lens-associated Red Eye

  https://www.reviewofcontactlenses.com/article/managing-contact-lensassociated-red-eye

  Patients with CLARE have an acute onset and wake up with symptoms of irritation to moderate pain, epiphora and photophobia. They often have prominent circumlimbal redness and may present with multiple, small focal or diffuse infiltrates that rarely stain with sodium fluorescein. There may also be associated corneal edema and haze.8-10 […] CLARE is not a difficult condition to manage, but it can take time to educate patients on the importance of compliance with lens wear cessation to minimize risk of recurrence. A detailed case history and careful examination to measure the size of the epithelial defect over the underlying infiltrate to rule out infiltrative keratitis, CLPUs and microbial keratitis are important in determining the appropriate management. With a clear understanding of the condition and the potential differentials, optometrists can effectively manage these patients.

• #2 thyroid-eye-disease-resources

  https://www.tedimpact.com/thyroid-eye-disease-pathophysiology

  Once activated, orbital fibroblasts proliferate and produce inflammatory cytokines and hydrophilic hyaluronan, which enlarges orbital tissue volume. […] Activated orbital fibroblasts differentiate into adipocytes and myofibroblasts, which contribute, respectively, to adipogenesis and fibrosis of the orbital tissues. […] The ensuing tissue expansion and remodeling leads to crowding in the fixed bony orbit, and this may have long-term sequelae. […] Cross talk between TSHR and IGF-1R, as well as IGF-1R-mediated immune function, may play a critical role in the pathophysiology of TED. […] In Graves disease, TSHR autoantibodies drive inflammation of the thyroid epithelial cell membranes; in TED, IGF-1R autoantibodies activate and cause inflammation of the orbital fibroblasts, which can lead to a range of clinical symptoms. […] Treating only the thyroid gland won’t treat TED.

• #2 Red Eye Remedies: New and Tried-and-True

  https://www.reviewofoptometry.com/article/red-eye-remedies-new-and-triedandtrue

  Prescription corticosteroids are often used in the treatment of ocular inflammatory conditions, as they are highly effective in suppressing inflammatory, allergic and immune responses, including signs of redness. Corticosteroids suppress phospholipase A2 as well as the expression of cyclooxygenase/PGE isomerase (COX-1 and COX-2). […] When a patient presents with hyperemia related to underlying inflammatory, allergic or immune responses, topical corticosteroids may help to rapidly improve signs and symptoms. However, they are known to delay healing and suppress the immune response and should, therefore, be judiciously prescribedespecially for keratitis of unknown etiology or for prolonged use, as steroids may exacerbate the prevalence of secondary bacterial, viral and fungal infections. […] In 2017, the FDA approved OTC Lumify (0.025% brimonidine tartrate ophthalmic solution, Bausch + Lomb) to relieve ocular redness due to minor eye irritation in patients older than age five.

• #2 Red Eye (Causes, Symptoms, and Treatment)

  https://patient.info/doctor/red-eye

  For diagnostic purposes the causes of red eye are commonly divided into those which are painful and those which are not. […] Urgent referral is warranted for potentially serious problems. Features suggestive of a serious condition which may warrant urgent referral include: Acute glaucoma, Moderate-to-severe eye pain or photophobia, Marked unilateral redness. The greater the redness, the more likely it is that the cause is serious. […] Chemical burns are an ophthalmic emergency and should be immediately irrigated before any steps are taken.

• #2 When a Red Eye is More than Meets the Eye:a Teaching Case Report on the Public Health Roleof the Eyecare Provider | The Journal of Optometric Education

  https://journal.opted.org/article/when-a-red-eye-is-more-than-meets-the-eyea-teaching-case-report-on-the-public-health-role-of-the-eyecare-provider/

  The pathogenesis of mumps-related endotheliitis varies from this and may be associated with the level of viremia, but the rarity of the condition makes further research difficult. […] Endotheliitis is not completely benign as endothelial cell loss can occur. […] Systemic treatment of recalcitrant HSV-related endotheliitis may be necessary (oral acyclovir or valacyclovir) along with topical corticosteroids. […] The Centers for Disease Control and Prevention (CDC) is a federal agency under the U.S. Department of Health and Human Services tasked with monitoring and prevention of disease. […] Vaccination is the most effective way to prevent the spread of epidemic parotidis. […] The MMR vaccine is highly successful in providing long-term protection against measles and rubella but is not as effective in maintaining immunity to mumps over time. […] A deeper understanding of those at risk for underlying, causative systemic disease will provide for more timely identification and diagnosis with the potential to reduce the spread of infection.

• #3 Red Eye Remedies: New and Tried-and-True

  https://www.reviewofoptometry.com/article/red-eye-remedies-new-and-triedandtrue

  Currently available OTC vasoconstrictors are -adrenergic receptor (AR) agonists that induce smooth muscle contraction but differ in their affinity for the 1- and 2- AR subtypes. […] Brimonidine is a third-generation selective 2-adrenergic receptor agonist. While 1-ARs appear to be present in arteries, 2-ARs appear to be primarily expressed in veins. […] Thus, the potential for vasoconstrictor-induced ischemia and responsive release of vasodilators is decreased with Lumify. Research suggests 0.025% brimonidine effectively reduces and maintains the reduction of ocular redness for four hours post-instillation without significant rebound following discontinuation. […] The right medications to use when managing conjunctival hyperemia vary depending on the severity and nature of the underlying pathology. Primarily supportive medications, such as artificial tears, which can be kept in the fridge to be applied cold, can provide relief and decrease redness by limiting allergens and supporting the ocular surface, but their efficacy is limited in truly reducing redness.

• #3 The Red Eye – Clinical Tree

  https://clinicalpub.com/the-red-eye/

  The majority of causes of red eye are associated with only mild to moderate irritation. […] If a patient has moderate to severe pain or pain that wakes them at night frequently, a more serious etiology should be considered. […] Vision loss is another important differentiating symptom in addition to pain. […] If vision has been affected, the underlying etiology is most likely one in which the cornea is involved (e.g., corneal ulcer or infiltrates) or an intraocular process causing associated external inflammation (e.g., iridocyclitis, endophthalmitis, and acute angle-closure glaucoma).

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