What should a nurse suspect in a patient with a painful red eye without discharge?

In a patient presenting with a painful red eye that does not have any discharge, iritis is a strong consideration. Iritis, also known as anterior uveitis, is characterized by inflammation of the iris, which can lead to significant pain and redness in the eye. Patients may also experience light sensitivity, decreased visual acuity, and a ciliary flush (a ring of redness around the cornea). The absence of discharge is a key feature that distinguishes iritis from conjunctivitis, as both bacterial and viral conjunctivitis typically present with some degree of discharge.

In contrast, bacterial and viral conjunctivitis often produce a purulent or watery discharge, respectively. Allergic conjunctivitis usually presents with itching and may be accompanied by watery discharge, but pain is typically less pronounced. Understanding these distinctions helps in accurately assessing and diagnosing eye conditions, making iritis the most fitting diagnosis given the symptoms of a painful red eye with no associated discharge.