SEEING RED
We have all experienced red or bloodshot eyes at one time or another. Eye redness occurs when the small blood vessels in the eye become dilated, inflamed and congested with blood. There are a number of causes of eye redness, most of which are not serious and do not require medical treatment, unless they persist or are accompanied by symptoms such as pain or changes in vision. The degree of redness is not usually related to the severity of the problem; red eyes sometimes look worse than they are!
Common Causes of Eye Redness
These range from lack of sleep to allergies, from irritants in the air to infections, from trauma to the eye to chronic health conditions.
Deficiencies in certain vitamins and amino acids, sensitivity to some foods and excessive alcohol consumption are often reflected in red eyes. Allergies to cosmetic products or not removing make up before going to sleep can cause red eyes. General allergic reactions, for example to pollen or pets, are often accompanied by red, watery, irritated eyes, and the common cold often manifests with red watery eyes as well as a runny nose.
Environmental factors include dust, lengthy exposure to the sun, dry air and chemical fumes. Eye redness may occur only the day after exposure to these irritants. Prolonged hours in front of the computer can lead to eye fatigue and red eyes.
Contact lenses can prevent sufficient oxygen from reaching the cornea. If the lenses are worn for too long or worn while sleeping, they can cause redness, irritation, infections and in more serious cases corneal ulcers.
More specific causes of eye redness are bacterial or viral infections in different parts of the eye. These are typically accompanied by a discharge and pain or discomfort. They include inflammation of the follicles of the eyelashes (blepharitis), inflammation or infection of the membrane that covers the eye (conjunctivitis or "pink-eye"), ulcers on the cornea, and inflammation of the uvea (uveitis). One of the first signs of a sty is redness, along with sensitivity and a swelling or small red bump that appears on the eyelid.
Eye redness may be one of the symptoms associated with chronic health conditions such as diabetes, hypertension, and liver disease, as well as a side effect of long term medication used to treat certain conditions. Childhood illnesses, particularly measles, are usually accompanied by red eyes.
A small bright red blood blotch sometimes appears in one eye after exertion or even a strong cough or sneeze. This subconjunctival haemorrhage occurs when a blood vessel just under the surface of the eye breaks. It looks uncomfortable but is not serious unless accompanied by pain. It will usually clear within a week to 10 days. Trauma or injury to the eye will typically cause the eye to appear red. Even if it is not painful it should be checked by a doctor or optometrist to rule out serious damage.
Acute glaucoma is characterised by a sudden increase in eye pressure, red eyes and pain. In such cases, immediate medical intervention is crucial.
When should you contact your doctor or optometrist?
The majority of cases of eye redness do not warrant emergency medical attention, and often the symptoms disappear on their own or can be relieved by applying a cold or warm compress to the eyes. However, medical attention is advised if there has been trauma to the eyes, the symptoms last longer than two or three days, there is pain or discharge from the eyes, or there are changes in vision or sensitivity to light.
Red Eyes in Babies and Children
Puffy red eyes in babies and children are common, and as with adults may be due to a variety of factors. Generally, they are not serious and tend to resolve within a day or two but parents need to be alert to signs such as discharge and obvious discomfort or pain that would necessitate a visit to the doctor. Allergies to irritants such as pet dander, cigarette smoke and pollen are thought to be the primary cause of red eyes. They may be associated with other allergic reactions. In some babies a blocked tear duct prevents adequate drainage of tears, resulting in swollen, crusty, puffy eyes. A red lump on the edge of the eyelid could indicate a sty which is uncomfortable but will probably go away in a few days. Conjunctivitis (or "pink eye") is a common occurrence in children and is highly contagious, spreading from one child to another especially at school. Conjunctivitis in a newborn can be indicative of a more serious infection which needs to be treated by a doctor.
Gently bathing the eyes with cotton wool and warm water removes crusting and relieves discomfort. If the infection persists antibiotic eyedrops may be prescribed. A cool compress or even cucumber slices over the eyes will constrict blood vessels and reduce swelling and inflammation.
Red Eyes in the Elderly
As we get older, the normal function of eye tissue decreases and age-related eye problems are common. These include cataracts, age related macular degeneration, glaucoma, diabetic retinopathy and dry eye syndrome. Red eyes may also be the result of blepharitis, conjunctivitis, corneal ulcers, or allergies. Certain medications for chronic health conditions in the elderly may cause red eyes.
Help for Red Eyes
Bathing the eyes with cotton wool and warm water removes crusting and relieves discomfort. A cool compress or even cucumber slices over the eyes will reduce swelling and inflammation. Wash the hands frequently, encourage hand hygiene in children and discourage them from touching or rubbing itchy eyes as this spreads infection. Use separate towels for family members with eye infections. Speak to your optometrist about using preservative-free contact lens solutions. Specific eye drop products may provide temporary relief from symptoms of eye irritation, such as redness and dryness, but they sometimes exacerbate the problem. Ask your optometrist for guidance on these.
Red Eyes in Photos
Red eyes in photos has nothing to do with inflamed, tired or infected eyes!
The human eye is capable of adjusting to different light conditions. The amount of light that reaches the retina at the back of the eye is controlled by the pupil. On a bright sunny day, the pupil will contract, allowing only a small amount of light to enter the eyes, while at night, the pupil will enlarge in order to allow as much light in as possible. When the light from the camera flash goes off in a room with dim lighting, the pupils are dilated, and do not have time to contract fast enough to adjust to the bright flash of light. A large burst of light reaches the back of the eye, reflects back off retina with its rich blood supply, and that reflection is captured by the camera. People with wider pupils are more likely to end up with red eye in photos, whereas those with smaller pupils are less likely to.