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A young man's red painful eye with small pupil — anterior uveitis; steroids + atropine. Anterior uveitis/iritis (pain, photophobia, circumcorneal redness, miotic pupil, cells/flare in anterior chamber): steroid drops suppress inflammation, cycloplegics (atropine) prevent synechiae (iris-lens adhesions) and relieve ciliary spasm pain. Posterior (floaters, vision loss — toxoplasmosis, TB, sarcoid: systemic workup — chest X-ray, HLA-B27, infections). HLA-B27 (ankylosing spondylitis — recurrent unilateral alternating). Endophthalmitis (post-cataract emergency — pain, redness, hypopyon: intravitreal antibiotics ± vitrectomy). The painful red eye with small pupil is uveitis — dilate the pupil, quiet the inflammation.