A Painful
Red eye

A Painful Red Eye

Case study
A man, 75 years of age, presents with a red, painful, watery right eye of 1 week duration. He describes photophobia but says his vision is not reduced or blurry. He was seen at another clinic after 2 days of symptoms and was prescribed topical chloramphenicol antibiotic eye drops. Despite using the eye drops for 5 days, there has been no improvement in his symptoms. The man has no
significant ocular past history.


Henry, 60 years of age, presented to his general practitioner with a 3 month history of blurred vision in the left eye on a background of decreasing vision in both eyes for around 6 months. He had not had his eyes examined for many years. His past medical history included hypertension, hyper-cholesterolaemia, type 2 diabetes mellitus, chronic renal impairment and peripheral vascular disease. Henry admitted to noncompliance with his medications and medical appointments.


Bilateral blurry vision


Mrs MS, 81 years of age, presented to the emergency department with a 2 day history of left eye redness, worsening pain and watering. She had a history of glaucoma surgery with intraoperative topical antimetabolite in her left eye 3 years earlier. Visual acuity was documented as 6/18 in each eye. She was diagnosed with viral conjunctivitis and discharged home without ophthalmic review.


Acute infective endophthalmitis

Steroid Associated Infective

Betty, 78 years of age, presented to the emergency department with an acutely painful discharging left eye on the background of a complex ocular history. While living overseas she had developed left eye herpes keratitis for which she sought treatment from an ophthalmologist. She had initially been prescribed oral valacyclovir tablets and then ongoing topical corticosteroid eye drops (dexamethasone 0.1%).

Steroid associated infective keratitis

Loss of vision

Bert, aged 80 years, presented to his general practitioner with sudden, painless loss of vision in his right eye 2 hours prior. He was an insulin-dependant type 2 diabetic, with a history of hypertension and dyslipidaemia. Right visual acuity consisted only of hand movements, compared to 6/6 vision in the left eye. There was a right relative afferent pupillary defect. Dilated fundus examination demonstrated multiple emboli in the arterial circulation, early arteriolar attenuation, and a cottonwool spot along the infero-temporal vascular arcade…

Sudden loss of vision

Diabetic Retinopathy

Diabetic retinopathy is a significant cause of vision impairment, especially affecting those of working age. There are two large, randomised controlled trials examining the effect of fenofibrate on diabetic retinopathy.

We summarise their findings, and report on the available safety data.

Use of fenofibrate in management of patients with diabetic retinopathy