Clinical Evaluation of Red Eyes in Pediatric Patients

Casey Beal, MD; Beverly Giordano, MS, RN, CPNP, PMHS


J Pediatr Health Care. 2016;30(5):506-514. 

In This Article


Patients with the chief symptom of a red eye are commonly encountered in the pediatric primary care setting, but with a focused history and examination, the diagnosis and management can be accomplished with confidence. Understanding the pathophysiology of each disease manifestation and when to utilize special tests such as fluorescein staining is essential to diagnosing and treating these patients. Certain signs that indicate that sight might be threatened are important to identify and require referral to an ophthalmologist. These signs include corneal abrasions, corneal opacities, recurrent or chronic symptoms, severe pain, photophobia, vision changes, or concern that the globe may be ruptured. In addition, topical anesthetic medication should never be provided to the patient, and topical corticosteroids should only be prescribed upon consultation with an ophthalmologist. With use of some simple techniques, pediatric patients presenting with a red eye can be fully evaluated in the primary care setting and treated or triaged with confidence.