Red eye: what you should know

Red, puffy eyes are not only due to crying or a sleepless night. Red eye may be due to a lot of causes, including irritation, inflammation and infections. What are the symptoms of red eye or conjunctivitis? Aside from the abnormally red color of the eye and undersurface of the lids, red eye also manifests in (source: Medscape)

Itchiness
Profuse eye discharge
Pain
Visual changes
Sensitivity to light

What causes red eye?

The most likely culprit for red eye is viral and bacterial infections. Other causes are:

Presence of foreign body in the eye
Corneal abrasion
Subconjunctival hemorrhage
Keratitis
Irritation due to chemicals
Allergies

According to a review by researchers from the Ohio State University College of Medicine in Columbus:

“Red eye is the cardinal sign of ocular inflammation. The condition is usually benign and can be managed by primary care physicians. Conjunctivitis is the most common cause of red eye.”

How is red eye diagnosed?

The Medscape feature recommends that doctors should check the following:

Thorough eye examination that would include the eyelids, corneal, pupil’s reaction to light, visual acuity, and the lacrimal sac (tear gland).
Patient medical history that would include allergies, use of contract lenses, and other illnesses that may or may not be seemingly related to the eye problem.

There are no specific tests that can be performed to distinguish between bacterial and viral infections of the eye but the symptoms may slightly differ.

Viral conjunctivitis usually does not present in visual problems or sensitivity to light. Pain is usually mild or absent. Lymphoid follicles under the surface of the eyelid are usually present. Eye discharge is watery.

Bacterial conjunctivitis, on the other hand manifests in pain and edema of the eyelid. Eye discharge is sticky, making the eyelids glues together upon awakening.

The authors continued:

“Red eye is one of the most common ophthalmologic conditions in the primary care setting. Inflammation of almost any part of the eye, including the lacrimal glands and eyelids, or faulty tear film can lead to red eye. Primary care physicians often effectively manage red eye, although knowing when to refer patients to an ophthalmologist is crucial.”

How is red eye treated?

Although uncomfortable and irritating, red eye is rarely serious and usually goes away by itself. In most cases, eye drops containing broad-spectrum antibiotics (ophthalmic antibiotics) are prescribed. Anti-histamines, anti-inflammatory agents and topical steroids may also be

In addition, patients should be advised to take precautionary measures as red eye due to infection is highly contagious.

The authors concluded:

“To prevent the spread of viral conjunctivitis, patients should be counseled to practice strict hand washing and avoid sharing personal items; food handlers and health care workers should not work until eye discharge ceases; and physicians should clean instruments after every use.”

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