By Dr. Jean E. Keamy
Patients commonly complain of red eyes. I thought a review of some of the common causes and associated symptoms of red eyes would help my readers. A big misconception is that all red eyes are contagious conjunctivitis. The associated signs and symptoms give clues to the right diagnosis and the right treatment.
A painless, extremely bloody, red eye without any other symptoms usually indicates a subconjunctival hemorrhage. A tiny blood vessel in the white part of the eye, the conjunctiva, can burst from rubbing the eye or excessive straining. It can also burst on its own from blood thinners such as aspirin, Coumadin, Plavix, fish oil, flax seed oil and vitamin E. Although a subconjunctival hemorrhage is the most dramatic of red eyes, it often resolves on its own without any treatment. It may take up to four weeks to completely clear.
Red eyes with burning, tearing — worse at different time of the day — can indicate dry eyes.
Sometimes vision will blur intermittently. Artificial tears, warm compresses and fish oil daily can help alleviate the symptoms and the redness. Visine, which promises to get the red out, can exacerbate the dry eyes while constricting the blood vessels. The Visine will actually temporarily fix the redness but make the underlying cause worse.
Red eyes with itching and no discharge, possibly associated with hay fever symptoms, is likely allergic conjunctivitis. Usually both eyes are symptomatic. This is not contagious. Usually if allergy medications do not help the eyes, over the counter or prescription allergy eye drops are necessary. The use of preservative free artificial tears also helps clear the eyes of environmental allergens.
Red eyes with a purulent yellow or green discharge with pain or itching is typically bacterial conjunctivitis. An antibiotic eye drop or ointment is usually required. It typically starts in one eye and then can spread to the other eye. Washing hands is encouraged.
Also sharing of linens is discouraged. Sometimes it is associated with a sinus infection.
Bilateral red eyes with a clear discharge, itching and mild sensitivity to light, associated cough, cold, stuffy nose or sore throat usually signifies viral conjunctivitis. Antibiotics do not cure viral conjunctivitis. Cool compresses, artificial tears and some steroid eye drops usually help with the symptoms. Viral conjunctivitis is extremely contagious.
Red eyes with extreme sensitivity to light and deep pain can result from more serious eye diseases like iritis, herpetic eye infections or ulcers of the cornea. I recommend if you have red eyes that you have an eye examination right away rather than treat and diagnosis yourself. A proper diagnosis at the onset will hasten the recovery.
Dr. Jean Keamy is a board certified ophthalmologist specializing in cataract surgery, refractive surgery, eyelid surgery and diseases of the eye. She owns Keamy Eye & Laser Centre at 24 Lyman St. in Westborough and can be reached at 508-836-8733. Learn more at www.seemedrkeamy.com. Archives of articles from previous issues can be read at www.fiftyplusadvocate.com.
