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“Until you’re sure what you’re dealing with, avoid physical connection with this kind of patient. If the red eye is caused by an infection, it can be transmitted easily. I’ve seen several ophthalmologists get nasty adenovirus infections-most likely from their patients-that put them unemployed for a significant timeframe.

“I make every try to not touch the contaminated patient actually,” he continues. “I like to shake hands with most patients, but I don’t tremble hands with red-eye patients. I never touch the patient’s eyelids with my hands also; I usually use a cotton applicator sticks to carry the lids when doing the examination.

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• Infection of the brain

Of course, you also have to teach your staff to do the same, because they’ll see the patient first. I tell my staff that whenever a patient has red eye, don’t be in a hurry to consider pressures. A glaucoma attack could present as a red eye, but until I start to see the patient and get the feeling that glaucoma is the nagging problem, I don’t want them to touch the patient or use my instruments on the patient. Also, I have to suppose that by the right time I enter the room, the individual has touched several dining tables or my slit light fixture.

So when we’re completed in an area that I think is infected, I quarantine the room. My team comes in with gloves and alcohol and completely wipes down all the surfaces-and they don’t spare the alcohol. “Obviously, if I think the problem is not infectious-viral or I’m not going to worry about this bacterial-then,” he provides. “But sometimes you’re not sure. That’s why you really should cool off from contact with a red-eye patient until you know what the problem is. • Look for swelling in the preauricular lymph node.

“A inflamed lymph node before the hearing is a classic sign of viral conjunctivitis,” Dr. Pflugfelder highlights. “Chlamydia can cause that also. So, that’s main things I check after I see someone with pink eye. • Ask if the patient is self-treating. “You need to be careful that the individual isn’t mixing up something of his own and putting it on or in the attention,” notes Dr. Koffler.

“People may hear or continue reading the Internet about a do-it-yourself remedy using herbal medications, or putting a tea compress on the optical eyes, thinking it will treat pink eyes. • If allergy might be the reason, consider getting smears when culturing for eosinophils. “If you take a culture, you can set aside a few of the specimen on a slide and ask pathology look at the cells,” notes Dr. Koffler. “Increased eosinophil cells are an average indication of allergy.

• In case there is an infection, look carefully at both conjunctiva and cornea. “Infection causes a papillary conjunctivitis, and the corneal lesions round tend to be, whitish infiltrates,” notes Dr. Koffler. “Viruses like herpes simplex or adenovirus tend to cause more of a follicle response on the conjunctiva. For the cornea, adenovirus will produce classical stellate lesions, while hepatic disease will produce dendritic lesions. • Consider topical cyclosporine A when dealing with both hypersensitive conjunctivitis and dried out eye.