2 In such cases, where trauma is suspected but the mechanism of injury cannot be clearly determined, talking to the child alone in a friendly and non-accusatory manner may be beneficial. Taking an accurate history of trauma can pose a challenge, such as in the case of a pre-verbal child or a teenager who might be reluctant to communicate, especially in the presence of a parent. This could be a physical impact, a foreign body or chemical exposure. It is important to elicit a history of recent trauma. Further history may need to be obtained from other family members or witnesses. 2 For a young child (aged ≤6 years), the history is often taken from the accompanying family member, who may not necessarily know the full story. The history-taking should begin with determining the duration of redness and involvement of one or both eyes, inquiring about any possible causes and seeking information regarding associated symptoms and signs such as blurring, photophobia, loss of vision, discharge and ocular pain, discomfort or itch. In children with shorter attention spans, it is best to obtain a brief history first, then examine the patient and obtain a more detailed history later. This article outlines the diagnosis and management of acute red eye conditions, highlighting those that require immediate referral to ophthalmic care ( Table 1 – PDF download only). 1 The differential diagnosis list is therefore extensive however, with careful history-taking and clinical examination techniques, a diagnosis can usually be made. 1 It can arise from inflammatory, infective or traumatic processes involving the globe itself or the structures around it. Acute red eye in a child is a common presentation in general practice.

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