Brief Answer:
Acute mucopurulent conjuctivitis, Acute Anterior Uveitis, Acute Glaucoma.

Detailed Answer:
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If you have not had any ocular injury red painful eye at this age can be one of the following.

1. Acute mucopurulent conjuctivitis
2. Acute Anterior Uveitis
3. An attack of angle closure glaucoma

I will provide you with the presenting symptoms and management for all 3 and then you have to decide on your own as how to proceed.

1. Acute mucopurulent conjunctivitis: Patient presents with mild pain, photophobia, red eye and copious mucopurulent discharge. Patient may
give history of seeing halos around lights.It usually occurs due to infection in the surrounding tissues as lids,paranasal sinuses and lacrimal sac.

Treatment
-Topical antibiotics as eye drops. Ciplox 0.3% one hourly
- Antibiotic ointment as Ciplox at bed time
- Avoid pad and bandage
- Try to eradicate source of infection
- Prevent spread of infection by avoiding the use of common soap, towel and handkerchief.

2. Acute anterior uveitis: Patient presents with pain, photophobia and
diminution of vision more than conjunctivitis. There is hyperlacrimation and the patient is more symptomatic.

Treatment
- Eye drop 1% Atropine 8 hourly is given
- Topical steroids as eye drop 1% Prednisolone acetate 2 hourly
- Systemic steroids as tablet Prednisolone 1 mg/kg body weight in severe cases.

3. Acute Congestive Glaucoma: It occurs in predisposed individuals with narrow angle of anterior chamber. Patient presents with intermittent episodes of headache, blurring of vision followed by sudden onset of severe pain in eye, forehead and ipsilateral face usually precipitated by dim light, stress
and anxiety. Patient has associated symptoms of prostration, nausea and vomiting.

Treatment:
- Immediate lowering of intraocular pressure with intravenous 20% mannitol 150 ml over 20 minutes.

- Give tablet Acetazolamide 250 mg 8 hourly

- Followed by eye drops 2% Pilocarpine every half hourly for 2 hours then every 6 hourly

- Eye drops 0.5 Timolol to be given 12 hourly.

Later on decision for surgery or LASER therapy to be taken by an ophthalmologist.

WORD OF CAUTION: Though i have given guidelines to diagnose your problem I do not recommend you to self diagnose and start treatment on your own. Kindly visit an ophthalmologist at the earliest because all the 3 conditions are considered ocular emergencies and treatment should be started immediately.

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