Primary care physicians are often the first to see a child with the complaint of eye pain. The eye examination in children is not easy, and the entities that can cause pain in children range from a foreign body in the cornea to the most serious amblyogenic (inducing decreased vision) and life-threatening conditions. Eye pain is a red flag for ocular and systemic conditions, either in a “quiet eye” or “red eye.” A detailed history of present illness; pertinent review of systems; close attention to the past medical, family, and social histories; and meticulous physical examination can help to determine the cause, establish the correct treatment, and serve as the basis for referral to a pediatric ophthalmologist if necessary.

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