- Previous ocular history
Easily forgotten, but essential. The patient’s red eye may be associated with complications of contact lens wear—for example, allergy or a corneal abrasion or ulcer. A history of severe shortsightedness (myopia) considerably increases the risk of retinal detachment. A history of longsightedness (hypermetropia) and typically the use of reading glasses before the age of 40 increases the risk of angle closure glaucoma. Patients often forget to mention eye drops and eye operations if they are asked just about “drugs and operations.” A purulent conjunctivitis requires much more urgent attention if the patient has previously had glaucoma drainage surgery, because of the risk of infection entering the eye.
- Medical history
Many systemic disorders affect the eye, and the medical history may give clues to the cause of the problem; for instance, diabetes mellitus in a patient with a vitreous haemorrhage or sarcoidosis in a patient with uveitis.
- Family history
A good example of the importance of the family history is in primary open angle glaucoma. This may be asymptomatic until severe visual damage has occurred. The risk of the disease may be as high as 1 in 10 in first degree relatives, and the disease may be arrested if treated at an early stage. For any disease that has a genetic component (for example, glaucoma), the age of onset and the severity of disease in affected family members can be very useful information.
- Drug history
Many drugs affect the eye, and they should always be considered as a cause of ocular problems; for example, chloroquine may affect the retina. Steroid drugs in many different forms (drops, ointments, tablets, and inhalers) may all lead to steroid induced glaucoma.
