Acute red eye is a common presenting complaint to primary care physicians.  A detailed history of the presenting symptoms and previous ophthalmological and medical history can narrow the differential diagnosis and aid in the interpretation of key examination findings. The lack of specialist equipment in the primary care setting, along with a very broad differential diagnosis, can cause difficulty in establishing the correct diagnosis, and in such cases a specialist ophthalmological opinion should be sought.   Serious vision-threatening conditions that present as red eye are rare and can occasionally be overshadowed by associated systemic symptoms; in light of this they should always be considered within the differential and excluded on examination. 
Similar conditions to acute red eye include orbital cellulitis and thyroid eye disease.
Well-recognised complications of acute red eye are dependent on the underlying aetiology. Conditions affecting the cornea, trauma, anterior uveitis, and angle-closure glaucoma can lead to impaired visual acuity. Scleritis, corneal ulceration, high-velocity foreign bodies, and trauma can lead to perforation of the eye.
Sunderland Eye Infirmary
JS declares that he has received travel and meeting costs from Novartis and Bayer.
James Cook University Hospital
PS declares that he has served on the advisory boards of and received a travel grants from Bayer and Novartis.
Consultant in Ophthalmology
Royal Victoria Infirmary
LC declares that she has no competing interests.
Assistant Professor of Ophthalmology
Cornea External Disease and Refractive Surgery Local Director
Long Island College Hospital Eye Center
MPE declares that he has no competing interests.
Professor of Ophthalmology and Vision Sciences
Centre for Vision Science
Queen's University Belfast
UC declares that she has no competing interests.
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