The Clinical Problem Solvers Episode 445 – #IDLove – Red Eye
Feb 17, 2026
Uttara, a second-year infectious disease fellow at Stanford focused on antimicrobial stewardship and global health, presents a puzzling red eye case. The conversation moves from ocular localization and autoimmune versus infectious causes to lung and brain findings. They trace a disseminated mycobacterial infection linked to unpasteurized milk and discuss diagnostic clues and management nuances.
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Red Eye That Signals Deep Disease
- Scleritis with pain and blurred vision suggests an inside-out process rather than simple conjunctivitis.
- Consider keratitis, scleritis, or uveitis when red eye is subacute/chronic and painful.
Lung–Eye Pattern Narrows Causes
- Simultaneous pulmonary and ocular findings narrow the differential to pathogens with systemic tropism.
- Think fungal, atypical bacteria including mycobacteria, and some parasites when lungs and eyes are both involved.
Avoid Geographic Anchoring Bias
- Don’t anchor on geographic buzzwords without considering noninfectious causes.
- Always weigh rheumatologic causes like RA-related scleritis alongside endemic infections.