The eye is often red, irritated and painful, with an increased amount of tears, similar to conjunctivitis. There may be a swelling of the lymph glands nearby, often in front of the ear. A fever and generalized illness may be present.

An examination shows a red, tender, inflamed eye with possible ulcers in the cornea (surface). Tender lymph nodes may be present, in front of the ear. These lymph nodes can fester, depending on the cause of the infection. A fever and other signs of generalized illness may also be found.

The white blood cell count may be high or low, depending on the cause of the infection. For many of the infections that cause Parinaud's syndrome, blood tests to check antibody levels are the main methods used to make a diagnosis. Sometimes, culture of the eye, lymph node, or blood or biopsy of the lymph node can be helpful.