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Quizzes > Health & Medicine > Diseases & Conditions

Red Eye Diagnosis Quiz: Identify Key Symptoms & Signs

Think you can complete 'the presence of pus is a sign of' question? Take our red eye symptoms quiz now!

Difficulty: Moderate
2-5mins
Learning OutcomesCheat Sheet
Paper art style red eye illustration on coral background with pus spots and lymph node drainage arrows for diagnosis quiz

Ever wondered if that scratchy, watery gaze means more? Take our free red eye quiz to test your know-how on common red eye causes and whether the presence of pus is a sign of infection or an allergic flare. In just a few questions, you'll pinpoint triggers, spot mild irritations versus serious issues, and know when to seek professional help. This red eye symptoms quiz guides you through lymph node drainage, systemic signs and an ocular red eye test to help you spot key warning signs with confidence. Curious to dig deeper? Try our do i have pink eye quiz or explore a quick do i have pink eye or allergies quiz to sharpen your skills - let's get started now!

The presence of purulent discharge in a red eye most strongly suggests which type of conjunctivitis?
Bacterial conjunctivitis
Allergic conjunctivitis
Chemical conjunctivitis
Viral conjunctivitis
Purulent or pus-like discharge is characteristic of bacterial conjunctivitis, commonly caused by Staphylococcus aureus or Streptococcus pneumoniae. Viral conjunctivitis typically produces a watery discharge rather than thick pus. Allergic conjunctivitis more often produces a mucoid or watery discharge accompanied by itching. AAO: Conjunctivitis
Preauricular lymphadenopathy is most commonly associated with which form of red eye?
Allergic conjunctivitis
Adenoviral conjunctivitis
Episcleritis
Bacterial conjunctivitis
Adenoviral conjunctivitis often leads to enlargement of the preauricular lymph nodes adjacent to the ear due to viral antigen presentation. Bacterial conjunctivitis rarely causes significant lymphadenopathy. Allergic forms are mediated by histamine and typically don't involve lymph nodes. NCBI: Conjunctivitis
Seasonal itching, red eyes, and cobblestone papillae on the tarsal conjunctiva are most consistent with which diagnosis?
Keratitis
Bacterial conjunctivitis
Viral conjunctivitis
Allergic conjunctivitis
Allergic conjunctivitis often presents with intense itching, seasonal variation, and large papillae ('cobblestone') on the upper tarsal conjunctiva due to histamine release. Viral and bacterial types cause more discharge and less itching. Keratitis involves corneal inflammation and pain rather than prominent itching. Mayo Clinic: Allergic Conjunctivitis
A watery discharge from the eye with follicular conjunctival reaction most likely indicates which etiology?
Allergic conjunctivitis
Viral conjunctivitis
Bacterial conjunctivitis
Scleritis
Viral conjunctivitis usually produces a watery discharge and follicular pattern on the conjunctiva, often associated with adenovirus. Bacterial infections produce purulent discharge and papillae rather than follicles. Allergic cases produce itching and papillae. AAO: Viral Conjunctivitis
Follicles on the conjunctiva are best described as:
Small, dome-shaped lymphoid aggregates
Elevated papillae with central vessels
Flat, red patches
Areas of conjunctival hyperpigmentation
Follicles are collections of lymphocytes that appear as small, dome-shaped, semi-translucent nodules on the conjunctiva. Papillae are characterized by a central vascular tuft and are often seen in allergic conjunctivitis. Flat red patches are more nonspecific erythema. NCBI: Follicular Conjunctivitis
Neonatal conjunctivitis presenting within 5 days of birth with copious purulent discharge is most likely due to:
Herpes simplex virus
Staphylococcus aureus
Chlamydia trachomatis
Neisseria gonorrhoeae
Gonococcal neonatal conjunctivitis usually presents 2 - 5 days after birth with severe hyperemia and copious purulent discharge. Chlamydial infections tend to present later, around 5 - 14 days. HSV typically causes vesicular lesions and is less purulent. CDC: Chlamydia
Initial management of uncomplicated bacterial conjunctivitis in adults usually involves:
Topical antibiotic drops
Topical corticosteroids
Topical antivirals
Immediate systemic antibiotics
Most cases of bacterial conjunctivitis in adults respond well to topical antibiotic drops such as erythromycin or fluoroquinolones. Systemic antibiotics are reserved for severe or systemic involvement. Antivirals and steroids are not indicated for simple bacterial conjunctivitis. AAO: Treatment Guidelines
A sectoral redness with minimal pain that blanches with phenylephrine is characteristic of:
Anterior uveitis
Conjunctivitis
Scleritis
Episcleritis
Episcleritis presents as a localized, mild redness and discomfort; application of phenylephrine causes blanching by vasoconstricting superficial vessels. Scleritis is deeper, more painful, and does not blanch. Uveitis and conjunctivitis have different clinical features. AAO: Episcleritis vs. Scleritis
A ciliary flush (limbic injection) most strongly indicates inflammation of the:
Bulbar conjunctiva
Episclera
Iris or ciliary body (uvea)
Lacrimal gland
A ciliary flush, seen as a violet ring around the corneal limbus, suggests deeper inflammation involving the iris or ciliary body, such as anterior uveitis or keratitis. Conjunctival or episcleral redness appears more peripheral. The lacrimal gland is not involved in corneal flush patterns. NCBI: Uveitis
Vesicular rash in the V1 dermatome combined with red, painful eye suggests:
Herpes zoster ophthalmicus
Allergic conjunctivitis
Bacterial keratitis
Viral conjunctivitis
Herpes zoster ophthalmicus involves reactivation of V1 (ophthalmic) branch of trigeminal nerve, presenting with a vesicular rash on forehead and eyelids along with ocular involvement. Allergic or viral conjunctivitis do not produce a dermatomal rash. AAO: Herpes Zoster Ophthalmicus
Severe eye pain, headache, mid-dilated nonreactive pupil, and high intraocular pressure indicate:
Acute angle-closure glaucoma
Episcleritis
Dry eye syndrome
Bacterial conjunctivitis
Acute angle-closure glaucoma presents with sudden severe ocular pain, headache, nausea, a mid-dilated pupil, and markedly elevated intraocular pressure due to blocked aqueous outflow. Other red eye conditions do not show these features or pressure spikes. AAO: Angle-Closure Glaucoma
Which eye drop is contraindicated in acute angle-closure glaucoma?
Brimonidine (an alpha agonist)
Pilocarpine (a miotic)
Atropine (a mydriatic)
Timolol (a beta-blocker)
Mydriatic agents like atropine further dilate the pupil, worsening angle closure by narrowing the anterior chamber angle. Miotics and aqueous suppressants are used to lower pressure and open the angle. NCBI: Glaucoma Management
A corneal ulcer with stromal infiltrate and epithelial defect is most indicative of:
Episcleritis
Bacterial keratitis
Allergic conjunctivitis
Viral conjunctivitis
Bacterial keratitis presents with an epithelial defect seen on fluorescein staining, an underlying stromal infiltrate, and often a mucopurulent discharge. Viral conjunctivitis does not produce stromal ulcers. Allergic and episcleral conditions spare the corneal epithelium. AAO: Keratitis
Contact lens wearers with severe pain disproportionate to exam findings and a ring-shaped stromal infiltrate most likely have:
Fungal keratitis
Acanthamoeba keratitis
Bacterial conjunctivitis
Herpes simplex keratitis
Acanthamoeba keratitis often affects contact lens users, presenting with severe pain that is out of proportion to clinical signs and a characteristic ring-shaped stromal infiltrate. Herpes simplex shows dendritic ulcers, not ring infiltrates. AAO: Acanthamoeba Keratitis
Which mediator is primarily responsible for itching in allergic conjunctivitis?
Prostaglandin
Interleukin-2
Histamine
Leukotriene
Histamine released from mast cells is the primary mediator causing intense itching, conjunctival hyperemia, and chemosis in allergic conjunctivitis. Prostaglandins and leukotrienes contribute to inflammation but are less directly associated with pruritus. NCBI: Ocular Allergy
Which of the following is not typically a feature of acute red eye?
Photophobia
Pain
Discharge
Fever
Fever is a systemic sign and not a direct feature of localized acute red eye, though it may accompany orbital cellulitis or systemic infection. Pain, photophobia, and discharge are common local symptoms of various red eye etiologies. AAO: Red Eye Overview
Dendritic corneal lesions on fluorescein staining are most characteristic of:
Herpes simplex keratitis
Fungal keratitis
Acanthamoeba keratitis
Bacterial keratitis
Herpes simplex virus causes branching (dendritic) epithelial ulcers that uptake fluorescein stain. Acanthamoeba produces radial perineuritis and ring infiltrates, while bacterial and fungal keratitis have different pattern of infiltrates and ulceration. AAO: Viral Keratitis
Deep, boring eye pain with a violaceous hue to the sclera that does not blanch with phenylephrine suggests:
Scleritis
Episcleritis
Conjunctivitis
Anterior uveitis
Scleritis involves inflammation of the deep scleral tissues and causes severe, boring pain often radiating to the face or head. The scleral redness does not blanch with topical phenylephrine, differentiating it from episcleritis. AAO: Scleritis
Which finding helps distinguish orbital cellulitis from preseptal cellulitis?
Conjunctival injection
Painful restricted extraocular movements
Mild chemosis
Eyelid erythema
Orbital cellulitis involves the orbit posterior to the orbital septum, causing painful, restricted eye movements and possible proptosis. Preseptal cellulitis is limited to the eyelid and periorbital tissues, sparing ocular motility. AAO: Orbital Cellulitis
Mutton-fat keratic precipitates on the corneal endothelium suggest:
Episcleritis
Viral conjunctivitis
Granulomatous anterior uveitis
Bacterial conjunctivitis
Mutton-fat keratic precipitates are large, greasy-appearing cellular deposits on the corneal endothelium, indicative of granulomatous inflammation often seen in conditions like sarcoidosis or tuberculosis-associated uveitis. They are not features of conjunctivitis or episcleritis. NCBI: Anterior Uveitis
Which systemic condition is most commonly associated with non-infectious anterior uveitis?
Diabetes mellitus
Ankylosing spondylitis
Hyperthyroidism
Hypertension
Ankylosing spondylitis is strongly associated with HLA-B27 and can manifest with acute anterior uveitis. Other seronegative spondyloarthropathies also have similar ocular associations. Diabetes and hypertension are not directly linked to uveitis. Uveitis.org
Phlyctenular keratoconjunctivitis is a hypersensitivity reaction most often triggered by:
Pseudomonas aeruginosa
Adenovirus
Tuberculosis proteins
Herpes simplex virus
Phlyctenular keratoconjunctivitis is a delayed hypersensitivity reaction to bacterial proteins, classically from Mycobacterium tuberculosis or staphylococcal antigens. It presents with small nodules (phlyctenules) near the limbus. Viral causes do not trigger this response. NCBI: Phlyctenular Keratoconjunctivitis
Which clinical feature helps distinguish episcleritis from conjunctivitis?
Tenderness on palpation of the sclera
Follicles
Mucoid discharge
Itching
Episcleritis may cause mild tenderness or discomfort when pressing on the globe, whereas conjunctivitis typically causes itching, discharge, and no significant globe tenderness. Episcleritis spares follicles and purulent discharge. AAO: Episcleritis
A localized, elevated conjunctival lesion adjacent to the limbus that grows onto the cornea is called:
Pterygium
Episcleritis
Pinguecula
Conjunctival nevus
A pterygium is a wing-shaped fibrovascular proliferation of conjunctiva that extends onto the cornea, typically medially. A pinguecula is a raised yellow-white deposit that does not encroach on the cornea. AAO: Pterygium
Which organism is the most common cause of fungal keratitis in tropical climates?
Adenovirus
Fusarium species
Candida species
Staphylococcus aureus
Fusarium species are filamentous fungi commonly implicated in corneal infections following trauma with vegetable matter, especially in tropical climates. Candida causes yeast keratitis more often in immunocompromised patients. PMC: Fungal Keratitis
A patient with rheumatoid arthritis and red eye is at highest risk for which ocular complication?
Viral keratitis
Pinguecula
Allergic conjunctivitis
Necrotizing scleritis
Rheumatoid arthritis can be associated with necrotizing scleritis, a severe, vision-threatening inflammation of the sclera. Allergic and viral conjunctivitis are not linked to systemic rheumatoid arthritis. AAO: Scleritis
Superior limbic keratoconjunctivitis is most often associated with:
Sarcoidosis
Diabetes mellitus
Rheumatoid arthritis
Thyroid eye disease
Superior limbic keratoconjunctivitis involves chronic inflammation of the superior bulbar conjunctiva and is associated with thyroid eye disease due to mechanical irritation from proptosis and lid retraction. Other systemic conditions are not typically linked. NCBI: SLK
Which clinical test is most useful for diagnosing herpes simplex keratitis?
Fluorescein staining revealing dendrites
Tonometry
Schirmer's test
Amsler grid
Fluorescein dye highlights the branching dendritic epithelial defects caused by herpes simplex virus. Schirmer's test measures tear production, tonometry measures pressure, and Amsler grid evaluates the macula. AAO: Herpes Keratitis
Which red eye condition often shows a 'waterfall' appearance of conjunctival injection?
Pinguecula
Allergic conjunctivitis
Acute angle-closure glaucoma
Bacterial conjunctivitis
Acute angle-closure glaucoma can present with ciliary flush described as a 'waterfall' of deep injection around the limbus. Conjunctivitis shows diffuse superficial injection, and allergic conditions show papillary changes. AAO: Glaucoma
Which diagnostic modality is most sensitive for detecting early scleral inflammation?
Ultrasound B-scan
Slit-lamp biomicroscopy alone
Fluorescein angiography
Optical coherence tomography (anterior)
Ultrasound B-scan can detect subtle scleral thickening and fluid collected in the episcleral and scleral layers, making it sensitive for scleritis. Slit-lamp may miss deep inflammation. OCT is better for cornea and anterior chamber, and fluorescein angiography is for retinal/choroidal vessels. PMC: Scleritis Imaging
In traumatic red eye, a flat anterior chamber with normal intraocular pressure suggests:
Episcleritis
Hyphema
Occult globe rupture
Angle-closure glaucoma
A flat anterior chamber in the setting of trauma, with normal or low pressure, strongly suggests a full-thickness eyeball rupture leaking aqueous humor. Hyphema raises IOP, angle closure increases pressure, and episcleritis does not alter the chamber depth. AAO: Globe Rupture
Which inflammatory cytokine is most elevated in aqueous humor during acute anterior uveitis?
Interferon-gamma
Tumor necrosis factor-alpha
Interleukin-10
Interleukin-6
IL-6 levels rise significantly in the aqueous humor during acute anterior uveitis, mediating inflammatory responses. TNF-alpha is elevated in posterior uveitis but less so anteriorly. Interferon-gamma and IL-10 play different immunoregulatory roles. PMC: Uveitis Cytokines
Which autoimmune marker is most frequently positive in patients with scleritis secondary to rheumatoid arthritis?
Rheumatoid factor
Anti-CCP (cyclic citrullinated peptide)
ANA (antinuclear antibody)
ANCAs
Rheumatoid factor is positive in the majority of rheumatoid arthritis cases and is associated with extra-articular manifestations like scleritis. Anti-CCP is specific but less sensitive. ANCA markers are related to vasculitis, and ANA is seen in lupus. NCBI: Rheumatoid Arthritis
Which condition can mimic acute angle-closure glaucoma but presents with normal or low intraocular pressure?
Uveal effusion syndrome
Phacomorphic glaucoma
Acute posterior scleritis
Exfoliation syndrome
Acute posterior scleritis may present with periocular pain, redness, and shallow anterior chamber mimicking angle closure but often with normal or low IOP. Phacomorphic glaucoma elevates IOP, and uveal effusion causes choroidal detachment. PMC: Posterior Scleritis
In ocular rosacea, which of the following is a common ocular finding?
Meibomian gland dysfunction
Serpiginous choroidopathy
Episcleritis
Granulomatous uveitis
Ocular rosacea often presents with meibomian gland dysfunction leading to blepharitis, tear film instability, and conjunctival injection. Granulomatous uveitis and serpiginous choroidopathy are not associated. Episcleritis can occur but is less specific than gland dysfunction. PMC: Ocular Rosacea
Which sign differentiates a corneal endothelial rejection in transplant from anterior uveitis?
Hyphema
Khodadoust line
Mutton-fat keratic precipitates
Cellular anterior chamber reaction
A Khodadoust line is a linear arrangement of endothelial rejection infiltrates on a corneal graft surface, indicating transplant rejection. Mutton-fat precipitates occur in granulomatous uveitis. Cellular reaction and hyphema can be seen in uveitis. PMC: Corneal Transplant
Which pharmacologic agent can precipitate acute uveal effusion leading to secondary angle closure?
Pilocarpine
Acetazolamide
Topiramate
Timolol
Topiramate can cause supraciliary effusion, forward rotation of the ciliary body, and secondary angle-closure glaucoma. Beta-blockers, carbonic anhydrase inhibitors, and miotics treat glaucoma and do not precipitate effusion. PMC: Topiramate Glaucoma
Which feature is most indicative of necrotizing scleritis?
Phlyctenular nodules
Follicular conjunctivitis
Sectoral conjunctival chemosis
Scleral thinning with visible uveal tissue
Necrotizing scleritis is the most severe form of scleritis, leading to scleral tissue loss and thinning that can reveal the underlying uvea or choroid. It is accompanied by intense pain and risk of perforation. AAO: Necrotizing Scleritis
Which organism is the most common cause of orbital cellulitis in children?
Staphylococcus aureus
Mucor species
Pseudomonas aeruginosa
Streptococcus pneumoniae
Staphylococcus aureus is the most common bacterial pathogen in pediatric orbital cellulitis, often spreading from sinus infection. Streptococci can also be involved but less frequently than staph. Pseudomonas and mucor are rarer. NCBI: Orbital Cellulitis
A red eye with elevated intraocular pressure and shallow anterior chamber after trauma suggests:
Neovascular glaucoma
Pigmentary glaucoma
Open-angle glaucoma
Angle recession glaucoma
Angle recession glaucoma results from tearing between longitudinal and circular fibers of the ciliary muscle after blunt trauma, leading to chronic IOP elevation and a shallow chamber. Other glaucoma types have different etiologies and chamber presentations. AAO: Angle Recession
Which genetic mutation is associated with familial granulomatous uveitis?
NOD2/CARD15
PAX6
CFH
HTRA1
Mutations in the NOD2/CARD15 gene are associated with Blau syndrome, presenting with early-onset granulomatous uveitis, arthritis, and dermatitis. CFH and HTRA1 relate to macular degeneration, and PAX6 mutations cause aniridia. PMC: Blau Syndrome
Which immunosuppressive agent is first-line for refractory non-infectious scleritis?
Mycophenolate mofetil
Methotrexate
Cyclophosphamide
Azathioprine
Methotrexate is often used as first-line steroid-sparing therapy in refractory non-infectious scleritis due to its efficacy and safety profile. Azathioprine and mycophenolate are alternatives, while cyclophosphamide is reserved for severe vasculitic cases. PMC: Scleritis Treatment
Which cell type is predominantly found in the subepithelial infiltrate of Mooren's ulcer?
Mast cells
Plasma cells
Neutrophils
CD4+ T lymphocytes
Mooren's ulcer shows a subepithelial infiltrate rich in CD4+ T cells, supporting an autoimmune etiology against corneal antigens. Neutrophils and plasma cells may be present but are not predominant. PMC: Mooren's Ulcer
Which advanced imaging technique is most useful for quantifying corneal nerve density in suspected small-fiber neuropathy presenting with red eye?
Ultrasound pachymetry
In vivo confocal microscopy
Anterior segment OCT
Scheimpflug imaging
In vivo confocal microscopy allows high-resolution imaging of corneal nerves and is used to assess small-fiber neuropathy in diabetic and other neuropathic states presenting with dry eye and discomfort. OCT and pachymetry measure structure and thickness, not nerve density. PMC: Corneal Nerve Imaging
Which biomarker in tear film correlates with severity of dry eye and secondary red eye?
Complement C3
Lactoferrin
Immunoglobulin A
Matrix metalloproteinase-9 (MMP-9)
Elevated tear MMP-9 indicates ocular surface inflammation and correlates with dry eye severity and associated redness. Lactoferrin and IgA relate to tear film defense, and complement C3 is not a direct marker of dry eye inflammation. PMC: Tear Film Biomarkers
Which advanced surgical technique is indicated for refractory necrotizing scleritis?
Pterygium excision
Conjunctival resection and amniotic membrane graft
Phototherapeutic keratectomy
Trabeculectomy
Conjunctival resection to remove inflammatory cells combined with amniotic membrane graft can help heal refractory necrotizing scleritis and prevent perforation. Pterygium excision and trabeculectomy address other conditions, and PTK is for superficial corneal scars. PMC: Scleritis Surgery
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Study Outcomes

  1. Interpret Pus-Related Clues -

    Apply knowledge that "the presence of pus is a sign of" bacterial conjunctivitis to differentiate it from non-infectious red eye conditions in our red eye quiz.

  2. Analyze Lymphatic Patterns -

    Assess lymph node drainage in ocular red eye test scenarios to distinguish localized infections from systemic disease.

  3. Identify Systemic Indicators -

    Recognize accompanying symptoms like fever and malaise in the red eye symptoms quiz to correlate ocular findings with overall health.

  4. Differentiate Common Etiologies -

    Distinguish allergic, viral, and bacterial causes by applying evidence-based criteria from the ocular red eye test.

  5. Enhance Diagnostic Confidence -

    Leverage interactive quiz feedback to sharpen decision-making skills and accurately diagnose common red eye causes.

Cheat Sheet

  1. Infectious vs. Non-infectious Red Eye -

    Understanding whether a red eye is inflammatory or infectious is crucial for any red eye symptoms quiz and ocular red eye test. According to American Academy of Ophthalmology guidelines, the presence of pus is a sign of bacterial conjunctivitis, while a watery discharge often indicates a viral cause. Use the mnemonic "PAV" (Purulent, Aqueous, Viral) to remember discharge types quickly.

  2. Discharge Type as a Diagnostic Clue -

    Examining the discharge - purulent, mucoid, or serous - helps narrow down common red eye causes. Bacterial infections produce thick yellow-green pus, allergic reactions yield stringy mucus, and viral etiologies create watery tears. Remember "YMS" (Yellow, Mucus, Serous) for rapid categorization during a red eye quiz.

  3. Lymph Node Drainage Patterns -

    Palpating regional lymph nodes can differentiate between viral and chlamydial conjunctivitis. Preauricular lymphadenopathy often accompanies adenoviral infections, whereas submandibular nodes may enlarge with chlamydia. This step is a frequent scenario in ocular red eye test case vignettes.

  4. Recognizing Systemic Signs and Red Flags -

    Severe pain, photophobia, or decreased vision alongside redness suggests deeper pathology like keratitis or uveitis. According to peer-reviewed journals, systemic symptoms (fever, joint pain) may point to autoimmune causes or systemic infections. Always include questions on systemic involvement in your red eye quiz for comprehensive assessment.

  5. Top Common Red Eye Causes Mnemonic -

    A handy mnemonic to recall the five top causes is "C-CUPG": Conjunctivitis, Corneal ulcer, Uveitis, Pinguecula irritation, and Glaucoma (angle-closure). This list covers most scenarios you'll encounter in a red eye symptoms quiz and quick ocular red eye test. Reviewing each cause with its hallmark features solidifies retention and boosts your confidence.

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