Red Eyes

By Prisca Diala, MD

Chesapeake Eye Care & Laser Center

. https://www.chesapeakeeyecare.com/

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Red Eyes

Eye redness is a symptom that frequently leads patients to seek medical attention. Various conditions can cause red eyes. Some are mild and self-limiting while others are very severe and sight-threatening. The trick to hashing out what is dangerous and what is not is to identify associated symptoms.
Let us start by distinguishing between the types of conjunctivitis. Viral conjunctivitis is a very frequent form of red eye that is associated with a clear, watery discharge that may be slightly thick. In contrast, bacterial conjunctivitis presents with a more thickened mucous discharge. Both entities have self-limiting varieties that require only supportive care until the condition runs its course but there are types that can threaten vision, especially those that start to affect the cornea. They would require immediate attention and treatment.
Allergic conjunctivitis presents with a similar type of discharge as viral conjunctivitis but the former is associated with moderate to severe itching. Allergic conjunctivitis can be further broken down to the seasonal type that tends to occur during the spring/summer months and the type that is present year-round but worsens during the spring/summer months. The latter type is seen in patients who suffer from asthma, eczema, hay fever and have a significant family history of these conditions.
Allergic conjunctivitis can at times be controlled with oral antihistamines alone and artificial tears to wash away eye irritants, but antihistamine eye drops are very effective if oral medication does not work. For mild forms, over-the-counter allergy eye drops are sufficient and can be used 1-2 times daily as needed. Moderate to severe forms require prescription strength antihistamine/mast cell stabilizer eye drops that require chronic use to be effective.
Sometimes patients spontaneously develop a sheet of blood on the whites of their eyes. This is called a subconjunctival hemorrhage where a blood vessel in that area has ruptured. This can occur during eye rubbing, valsalva maneuvers and in people who take blood-thinners such as aspirin, plavix, or warfarin. The hemorrhage looks quite alarming but it resolves on its own without any consequence to vision.
Contact lens wearers beware of red eyes, pain, light sensitivity, and/or reduced vision. These could be signs of a serious eye infection that requires prompt treatment. This infection could be a result of contact lens intolerance, over use or misuse (sleeping with contacts, not changing the solution in the lens case daily, new solution or contacts that do not fit well).
A thorough eye exam can help distinguish between all of the above conditions so that appropriate therapy can be instituted if needed. So, next time you suffer from red eyes, see an ophthalmologist and get a thorough evaluation.