Redness in the eyes can be caused by infection, inflammation, high blood pressure, allergy, dry eye, foreign body, growths, and others. It can be difficult to determine the cause of inflammation treating for one thing may not be appropriate for another.
This patient woke up with redness on the top part of the eye. It is mildly uncomfortable. There is actually a nodule or bump and there are no abrasions on the surface. There is no mucous coming out of the eye. This is an episcleritis, specifically nodular episcleritis. It is treated with topical steroids and/or oral non-steroidal anti-inflammatories. It is a non-infectious inflammation, although I have seen herpes simplex virus masquerade as episcleritis. That is why is it very important for a doctor to follow a patient using topical steroids very very closely, as steroids will make herpes simplex much worse. Doctors must feel comfortable managing this or they should refer.
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