A 31-year-old presents to their GP complaining of an uncomfortable, red left eye with mild blurring of vision and significant lacrimation. Examination after instillation of a drop of local anaesthetic and fluorescein reveals a large area of uptake.A primary care physician should enquire about onset, pain, progression, and risk factors, as follows.### OnsetAcute onset often follows ocular surface trauma. Repeated episodes of ocular discomfort and lacrimation on wakening in the morning are pathognomonic of recurrent corneal erosion syndrome. Chronic mild or moderate ocular discomfort that worsens as the day progresses or during certain tasks, for example, reading or computer work, is typical of dry eyes or blepharitis.### PainIt may be useful to ask the patient to score any pain on a scale of 0–10. A high score is more likely to be associated with microbial keratitis or a mechanical abrasion.### ProgressionSpontaneous and rapid resolution of pain, typically within 24 hours, is common in mechanical abrasion, whereas untreated microbial keratitis becomes …
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