A 34 year old female with no past medical or ocular history presents to the eye clinic with a red right eye which has been present for the last 48 hours. Approximately 4-5 days ago, she began having symptoms of a cold and this was later followed by the red eye. The eye is not painful or itchy and she reports no visual symptoms. She says most of the discharge is watery, although this morning she did feel her lids “crusted together”.
On exam, best-corrected visual acuity is 20/20 bilaterally. A tender right pre-auricular node is palpable. External exam of the right eye is shown below. (On slit lamp exam multiple follicles are seen on the inferior conjunctiva. There are also sparse subepithelial infiltrates of the cornea, with no fluorescein staining of the corneal epithelium. Posterior segment exam is normal).
