Patients presenting with red eye(s) constitute one of the commonest encounters for eye-related conditions in general practice in Singapore. The Singapore Health survey in 2001 showed that conjunctivitis was ranked 10th amongst the most frequent conditions seen by primary practitioners1. It was reported that these cases account for 1 to 4 percent of all family practice consultations in the United States2. In a large scale survey of 8742 general practitioners (GPs) in the United Kingdom, 68% of them admitted that they had ‘some uncertainties about eyes’ and 10 percent affirmed the statement ‘eyes scare me stiff’3. The survey showed that less than 30% of GPs everted the eyelids of their patients with eye complaints, performed visual field/acuity testing or used fluorescein stain3. Little is known about the practice of primary care physicians (PCPs include both GPs and doctors working in public primary care centers) in managing common acute eye diseases in the local community. Apart from conjunctivitis, there are other differential diagnoses to consider if patients present with red eyes to the PCP, some of which carry a potentially high risk of complications and morbidity. History and clinical examination remain as key steps in the diagnosis of “red eye”. Local primary care clinics are equipped with hand-held opthalmoscope required for basic eye examination but the use of slit lamp or fluorescein strip is very limited. In view of the constraints, the challenges facing the PCP will be to derive at the most probable diagnosis promptly, so as to ensure that timely and appropriate therapy is instituted for rapid recovery and minimal complication. An evidence-based systematic approach will facilitate the PCP in managing common eye conditions. This review paper attempts to answer the following practice questions: 1. What the medical terms used to describe the “red eye”? 2. How can the PCP differentiate the various causes of “red eye”? 3. What are the microbial causes of conjunctivitis? 4. What is the rationale for using topical eyedrops in treating conjunctivitis? 5. Are topical antibiotics necessary?