Red Eye – Common causes

By Mr Gregory See Toh

Red-eye is the enlargement of the blood vessels in the conjunctiva making your appear redder than it usually does. In this article, we try to summarize  the common causes for red eyes and how it can be treated/prevented

What are common causes of a red eye?

1. Allergies
2. Bacteria Infections
3. Viral Infections
4. Poor contact lens fitting
5. Dry eyes
6. Glaucoma

1) Allergies

Extracted from: https://hickeysoluhttps://hickeysolution.com/allergic-conjunctivitis/tion.com/allergic-conjunctivitis/ on 16 Jun 2018

Allergic conjunctivitis can be caused by dust, pollen, pet fur/hair or foreign objects. It can be both acute and chronic. In both instances, it is important to identify the causative agent. The treatments are symptomatic relief.

Patients would have the following signs & symptoms

• Red eye
• Swelling
• Itchiness
• Slight burning sensation
• May also accompanied by a runny nose

Treatments

Your optometrist will be able to pick up allergic conjunctivitis and recommend you OTC eye drops. In more severe cases, a visit to the ophthalmologist may be in order for stronger anti-inflammatory/ steroid eye drops.

Intervention

• Close windows during allergy season

• Keep your home/workplace dust-free

• Use an indoor HEPA air purifier

• Be aware of your allergies and try to avoid them. Should contact with allergens be inevitable, your doctor might be able to prescribe you mast cell stabilizer to reduce the severity of the symptoms. 

2) Bacteria Infections

It can happen to both contact and non-contact lens wearers. This condition can cause visual impairment if treatment is delayed, hence it is important to have it treated as soon as possible. In most bacterial infection, the discharge is often yellowish/greenish and sticky.

Extracted from: https://www.emedicinehealth.com/image-gallery/bacterial_conjunctivitis_pink_eye_picture/images.htm on 16 June 2018

Signs and symptoms

• Red eye
• Sticky discharge
• Photophobia
• Tearing
• Gritty feeling
• Intolerance to Contact lens
• Pain

Treatment

Your optometrist should be able to discern a bacterial infection vs allergic reaction. In a bacterial infection, a visit to the eye specialist will be required. Besides antibiotic eye-drops, your eyes will be checked thoroughly to make sure that the infection did not spread to the back of the eye. For contact lens users ill-fitting contact lenses or extended hours of lens wear can make you more pre-disposed to opportunistic infections. 

Interventions

• Good hygiene
• Avoid sharing of towels etc
• For contact lens users, have your eyes check at least once a year by your optometrist.

3) Viral infections

Viral infection can be extremely contagious. Viral eye infections can be accompanied with common cold, measles, chicken pox and other systemic viral infections.

Signs and symptoms

• Redness
• Swollen Lymph Nodes
• Itching
• Clear watery Discharge
• Gritty feeling
• Pain
• Swelling or clouding of the cornea
• Photophobia

Treatments

Viral eye infections are usually self-limiting, lasting about a week for mild cases or up to 3 weeks for severe cases. In mild cases, your optometrist will be able to diagnose and prescribe you ocular lubricants for comfort. Should it not resolve in a week, an ophthalmologist or doctor would prescribe antiviral and/or steroids.

Interventions

Viral infections are very contagious thus patients should take note of the following:

• Use hand sanitizer or practice proper hand hygiene before touching your eye
• Avoid touching infected patient
• Avoid sharing body contact items such as towels or pillows

4) Poor Contact lens fitting

It is important to have your contact lens properly fitted. Prolong usage of the wrong material and parameter of the contact lens can result in damage to the sensitive cornea tissue. Getting your contact lens from an online store with no physical store (which is not legal in Singapore) may be cheaper, but there is no telling if the lens is counterfeit or not. Very often, counterfeit lenses are produced in poorly equipped facilities that increases the risk of an eye infection or damage. 

Signs and Symptoms

• Limbal injection (red-eye)
• Lid redness
• Discomfort
• Tearing
• Photophobia
• Lens intolerance

Treatments

Before new lens are being fitted your optometrist may recommend a lay off period. He/she will re-examine your eyes to fit a you with the appropriate lens and it’s recommended to come back for an annual review to ensure that the contact lens is still a good fit.

5) Dry eyes

Dry eyes is can be due to lack of tears or rapid evaporation of the tear film, resulting in damage to the cornea surface. It can also be due to over wearing of contact lenses

Signs and symptoms

• Red eyes
• Gritty feeling
• Stinging
• Excess tear production
• May experience blurring of vision

Treatments

• Ocular lubricants
• Omega 3 supplement
• Lid scrubs
• Short course of steroid eye drops in severe cases
• Punctal plugs to retain the tears in your eyes

Extracted from: https://www.medicalnewstoday.com/articles/315681.php on 16 June 2018

Interventions

• Try to avoid air-conditioned rooms or anywhere with a dehumidifying effect. A room humidifier may help
• For contact lens wearer, ask your optometrist for options of higher oxygen permeability contact lenses and the right lubricants to go along with it

6) Glaucoma

Acute angle closure glaucoma is caused by a rapid or sudden increase in intraocular pressure (IOP), the pressure within the eye. It can happen due to genetic pre-disposition or due to eye injuries. 

Extracted from: http://paulwashburn2.typepad.com/blog/2012/07/topamax-closed-angle-glaucoma.html on 16 June 2018

Signs and symptoms

• Ciliary flush (red eye)
• Pain
• Blurring of vision
• Seeing halos
• Nausea
• Severe Headache

Treatments

This is an ocular emergency that needs to be attended to urgently. The doctors will use either laser treatment and/or medication to reduce your eye pressure to prevent irreversible vision loss.

 

In Summary, most cases of red eyes may have similar signs and symptoms. Hence it is important not to self diagnose and self treat. Do not use OTC eye whitening eye drops as such drops mask the symptoms and can make the original condition worse. Visit your optometrist or ophthalmologist for an eye exam.