Constant Red Eyes
Author – Dr Japie Grové
One of the most common problems encountered by ophthalmologists is that of chronic red and irritated eyes. Studies show the problem to be more prevalent among woman and people older than age 50. Although there are hundreds of possible causes for this problem, the three major culprits are Dry eye syndrome, Blepharitis, and Allergic Conjunctivitis.
Dry eye syndrome (DES):
It was shown that up to 20% of the United States population suffers from mild DES and at least 7.8% of woman and 3.5% of men will have moderate to severe DES. Symptoms include constant redness, blurry vision and a gritty irritated feeling almost like having sand in the eye. Lifestyle adjustments can help with the symptoms: avoid air conditioned places, Air humidifiers, wearing “wrap around” sunglasses on windy days and eating food rich in Omega 3/6 like salmon or flaxseed oil etc.
The mainstay of therapy is artificial tear supplements; there is a whole range of products from artificial tear drops to viscous gels and ointments. If ordinary artificial drops is not relieving the symptoms an Ophthalmologist’s advice should be sought. It is sometimes necessary for the ophthalmologist to block the tear ducts with specially designed punctum plugs or to use more potent medication like Cyclosporin to get the symptoms under control.
Blepharitis refers to inflammation or infection of the eyelid glands and or lash follicles. In a study done in Italy 36% of patients seeking medical attention for red irritated eyes were diagnosed with Blepharitis.
Apart from red eyes, patients usually complain about crusting of the eye lashes, a heavy feeling of the eyelids and a foreign body sensation. Symptoms are usually worst in the morning and in dry ,warm weather. The eyes are also irritated and teary. Blepharitis will destabilize the tear film, causing or worsening existing DES. Patients can ease the symptoms with regular lid scrubs (cleaning the eyelids with diluted baby shampoo or commercially available lid cleaner) and hot compresses on the eye lids (cosmetic cotton discs soaked in hot water works just fine). Make-up on eyelid margins should also be avoided. Ophthalmologists will prescribe artificial tear supplements, anti – inflammatory drops and antibiotics. Blepharitis is best treated by an ophthalmologist as prolonged cases can cause scaring of the lid margins and permanent loss of lashes.
The conjunctiva is the outer lining of the eye and inside of eyelids. Allergies have a big variety of causes like pollen, dust, pets, make-up etc. In most cases finding a specific cause can be very difficult. A Skin prick tests can sometimes be of use. To avoid the specific cause, if found, is mostly impractical. Treatment include antihistamines, mast cell stabilizers, anti-inflammatory drops and steroids. The incidence of allergic conjunctivitis differs from one region to the other and is usually seen in children and young adults.
Other frequently seen causes:
- Infections of the conjunctiva (especially viral infections) can sometimes have a prolonged course.
- Extended contact lens wear.
- Frequent use of vasoconstriction drops (“eye whitening drops”) – cause a rebound redness called conjunctivitis medicamentosa.
- Uveitis is inflammation inside the eye causing a very painful, light sensitive, red eye.
- Eyelid abnormalities usually seen in older people (inward or outward rotation of the eyelid margin) often leaves the eye exposed leading to a red irritated eye. That needs to be corrected surgically.