A 65-year-old man complains of acute foreign-body sensation about his right eye, followed by blurred vision. Previously, he had normal vision in both eyes. In looking at this eye, you might diagnose?

Review Topic

Correct. Keratitis is an inflammation of the cornea. Common causes are infection and trauma. Patients will present with blurred vision, eye pain, and foreign body sensation. Examination may reveal a patchy loss of corneal transparency and circumcorneal hyperemia (“ciliary flush”). If the damage is on the corneal surface, topical fluorescein will stain the affected areas green.
Incorrect. Conjunctivitis, an inflammation of the mucous membrane that lines the sclera and inner surfaces of the eyelids, presents with a diffusely red (hyperemic) conjunctiva, and is usually accompanied by serous, mucoid, or purulent discharge. Vision loss is unlikely, and foreign body sensation does not occur. Conjunctivitis does not usually cause a corneal surface abnormality. Try again!
Incorrect. Endophthalmitis, or intraocular infection, can present with a hazy cornea and compromised vision, but there will also be severe pain, a red swollen conjunctiva, and an hypopyon (pus at the base of the anterior chamber). Try again!
Incorrect. Acute angle-closure glaucoma can present with blurred vision and a hazy cornea, but the corneal haze will be diffuse because it reflects loss of corneal endothelial function from extremely high intraocular pressure. The patient’s chief complaint with acute angle-closure glaucoma is deep ocular pain, not foreign body sensation. Try again!