A 17-year-old male presents to your office with a red left eye. He says that last night he began having pain, redness, and irritation, and upon wakening today the symptoms were much more severe. At first the discharge was scant, but over the course of the day worsened such that he has to continually wipe away “thick, green” material.
On exam, visual acuities are 6/6 in the right eye vs. 6/15 in the left eye. The right eye is not injected and is grossly normal on slit lamp examination. On examination of the left eye, there is severe injection and bogginess of the conjunctiva 360 degrees with abundant mucopurulent discharge. Peripheral corneal infiltrates and a 1+ cell reaction are also present. There is an enlarged preauricular lymph node on the left side.
External appearance of the left eye is shown below: