“My eye’s red and sore — is it just conjunctivitis?”

An acute red eye with PAIN, PHOTOPHOBIA and REDUCED/BLURRED VISION is NOT simple conjunctivitis — and in a CONTACT-LENS wearer (especially with sleeping-in/over-wear) it is microbial/contact-lens-associated keratitis (corneal ulcer) until proven otherwise: a sight-threatening emergency needing SAME-DAY ophthalmology (College of Optometrists Clinical Management Guidelines on microbial and contact lens-associated keratitis), lenses out immediately, lenses/case for culture, and absolutely NOT phone antibiotic drops (and never blind steroid drops, which can be catastrophic in herpetic/microbial keratitis). Keep the wider can’t-miss differential in mind — acute angle-closure glaucoma (severe pain, headache, nausea/vomiting, halos, hard red eye), anterior uveitis, scleritis, foreign body/abrasion — each needing same-day eye assessment. The examinable hidden agenda is work-driven avoidance plus embarrassment about lens misuse, leading her to minimise the pain and gloss the lens history; elicit it without shaming so she discloses and accepts assessment, convey the threat to sight calmly, and safety-net the escalation red flags. Simple infective conjunctivitis is usually bilateral or spreads, with discharge/stickiness, mild discomfort, NO true pain, NO photophobia, NO visual loss. Pain + photophobia + reduced vision + contact lenses = keratitis until proven otherwise. Antibiotic drops over the phone would be the classic dangerous error.