Doc, Why Is My Eye Red?
Here at Optique, we see and treat a variety of red eyes. Redness is caused by inflammation of the blood vessels in the conjunctiva, which is a thin, transparent layer that is located on top of the sclera (the white part of your eye). There are many possible causes for redness, including but not limited to infections, inflammation, allergies, and dryness. Some causes are benign and self-limiting, while others may be vision-threatening or even correlated with a systemic disease. Our responsibility is to diagnose accurately and provide an appropriate treatment plan.
When you are in our exam chair, we ask a few key questions to help guide us to the diagnosis. When did it start? How long has it been going on? Is it affecting one eye or both eyes? What other symptoms are you experiencing – pain? itching/irritation? light sensitivity? discharge? For example, itchy and watery eyes that have been going on for a month may indicate a chronic allergic conjunctivitis, while pain and light sensitivity in a contact lens wearer may indicate a corneal infection. We also review your medical history to identify risk factors including recent illness, eye injury or trauma, exposure to chemicals, and autoimmune diseases. The process of diagnosing the cause of a red eye often starts before the physical examination.
After a thorough case history, we check your vision. Conditions such as mild conjunctivitis or episcleritis do not affect vision. Decreased vision is often associated with corneal infections or abrasions, uveitis, or acute glaucoma.
When we look behind the slit lamp (a specialized microscope), we closely observe the pattern of redness. Redness that affects the entire sclera often points us to conjunctivitis or a reaction to a foreign body. Redness that is only affecting one part of the sclera, also known as sectoral redness, can indicate episcleritis, a corneal ulcer, or inflammation within the eye. We also evaluate the eyelids and eyelashes, cornea, and anterior chamber (the area between the cornea and the iris – the colored part of your eye) for signs of inflammation. We may also utilize fluorescein dye to highlight areas of damage to the cornea, allowing us to check for scratches, ulcers, or areas of severe dryness. With this thorough examination, we are able to determine whether the redness is caused by a surface irritant or by systemic inflammation.
At our practice, if we see signs of infection, we utilize state-of-the-art technology including polymerase chain reaction (PCR) testing to determine the specific infective agent. This guides us to tailor our treatment plan specific to your eyes and ensure the best outcome to preserve your vision.
Red eyes happen for many different reasons, and finding the underlying cause is critical for proper treatment. Some of the most common causes are bacterial or viral conjunctivitis, allergies, dry eye, contact lens related red eye, corneal abrasion, and uveitis. We encourage patients to seek immediate care with any redness accompanied with pain, vision loss or blurred vision, light sensitivity, nausea or headache, or known chemical exposure. Here at Optique, we evaluate each red eye in a systematic way, from a thorough case history to a detailed slit lamp examination, to protect your vision and overall health.
