A woman with an aching, red eye

Case presentation

A 38-year-old receptionist presented to her GP during spring with a three-day history of an aching right eye with mild redness. She said the ache radiated to her brow and that at times she felt nauseated. The eye felt bruised and the pain was worse with reading. She wore contact lenses on weekends only, and she thought her glasses were causing glare when she was working on a computer or driving at night.

On questioning, the patient reported that the eye had been intermittently red over the previous winter since a flu infection but had not been painful previously. She had a history of oral cold sores each summer, and the previous spring she had been excluded from contact lens wear by her optometrist because of a herpes dendrite on her right cornea.