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Irritated Eyes
Seeing red
Some mornings we look into the mirror and they are staring back at us: dry, irritated, bloodshot eyes. Hopefully, this is just the sign of a late night, but persistently irritated and burning eyes could indicate a more serious problem, like an eye infection or allergic reaction.
Our first instinct is to use over-the-counter eye drops to help soothe our eyes and reduce the redness. These may provide temporary relief, but they do little or nothing to treat the underlying causes of irritation. In fact, they can dangerously mask them, possibly worsening the problem later on.
Fortunately, other over-the-counter remedies can treat many causes of eye irritation. But when eye problems worsen or persist over time, it's wise to get your eyes examined to rule out the possibility of a more serious condition. Your ophthalmologist may suggest a prescription medication to help treat the problem.
Your eyes are complex and delicate organs. Keeping them healthy is important in ensuring that they will provide you with good service throughout your life.
Detailed Description
The comfort of your eyes depends on several factors, including the proper production of tears, the correct function and position of the eyelids, and the absence of infections and allergic reactions. All these factors must happen for the eye to be comfortably lubricated.
Eye irritation often happens when parts of the eye swell in natural response to infection or allergic reaction. The cornea-- the clear part of the eye covering the iris and the pupil-- is a sensitive layer of tissue. Even a small amount of inflammation of the cornea or the nearby tissues can cause a great deal of discomfort. Eye redness occurs when blood vessels in the conjunctivae (the thin, clear tissue layer covering the "white" of the eye) dilate. This is in response to infection, dryness, allergies, and other problems.
Eye irritation comes in many forms and can signal many different problems. By making note of whether your eyes burn, water, become red, or produce a discharge, you and your doctor can more correctly determine the source of the irritation.
Possible Underlying Causes
Conjunctivitis, also called pinkeye, is a major cause of irritated eyes. Conjunctivitis is a swelling of the conjunctiva, the layer of tissue overlaying the white of the eye (the sclera) and the inside of the eyelids (the bulbar conjunctiva). The two types of conjunctivitis are allergic and acute. Viral or bacterial infections cause acute conjunctivitis, the most common eye disease.
A wide variety of environmental allergens can cause allergic conjunctivitis. If you have hay fever, you know firsthand that watery, itchy eyes are the usual symptoms. Adopting a kitten, switching contact lens solutions, or using a different kind of soap or cosmetic can aggravate your eyes. Chemical irritants and air pollution can also cause conjunctivitis.
Inflammation of the eyelid can cause a burning, gritty sensation of the eye. If an eyelid is lax, it can turn inward or outward, causing the lashes to rub against the eye or the eye to become exposed. Styes (small, pus-filled abscesses on the eyelid that cause the feeling of something foreign in the eye) can also cause extreme discomfort.
Finally, eye irritation can happen in response to a poor night's sleep, extended exposure to wind or sun, or contact with environmental chemicals. Use artificial tears to help soothe your eyes by restoring your eye's moisture until your natural film of tears returns.
Triggers of Irritated Eyes
Exposure to known allergens, such as grass or air pollution, may cause eye irritation.
Drugs That Can Cause or Aggravate Irritated Eyes
Retinoids such as etretinate and acitretin may cause eye irritation or dryness.
Diagnosing the Underlying Cause
Eye irritation has many possible causes. A doctor can treat almost all of them quickly with early detection and intervention. Some causes may be due to an underlying disease or disorder of the entire body, in which case they may be accompanied by other symptoms that are characteristic of the disorder.
The following conditions may include eye irritation among their symptoms, but the presence of eye irritation should not lead you to conclude that you have a more serious disorder. You should not attempt to diagnose yourself with a medical condition, even if your symptoms match the characteristics of a certain disorder. If your symptoms concern you, the best thing to do is to seek medical advice. In order to understand your symptoms and reach a diagnosis, your doctor will consider your medical history, which symptoms you have, and the results of an ophthalmologic examination and laboratory tests.
Eye irritation unaccompanied by any other symptom
- Glaucoma: increased pressure of the fluid within the eye with progressive blindness
- Chlamydia: Sexually transmitted disease
- Migraine headache
- Hyphema: blood within the eye
- Neuralgia: pain caused by nerve damage or irritation
- Sinusitis
Eye irritation accompanied by discharge or tearing
- Blepharitis: inflammation of the eyelids
- Conjunctivitis (pinkeye): itching and redness of the eye due to infection or allergy
- Corneal abrasion: disease of the layer of tissues covering the iris and pupil
- Cluster headache: an extremely painful but uncommon type of migraine headache
- Entropion/ectropion: inward- or outward-turning of the eyelid
- Herpes zoster (shingles): a viral infection of the nerves that can affect the eye
- Scleritis and episcleritis: inflammation of the sclera, the white part of the eye
- Uveitis and iritis: inflammation of the uvea, a group of structures in the eye that includes the iris
- Styes: small, pus-filled abscesses on the eyelid, causing the feeling of something foreign in the eye
Eye dryness
- Corneal deterioration or infection: disease of the layer of tissues covering the iris and pupil
- Rheumatoid Arthritis: joint pain, stiffness, weakness, and inflammation due to autoimmune disease
- Sjgren's syndrome: a chronic inflammatory disorder characterized by excessive dryness of the eyes, mouth, and other mucous membranes
- Dry eyes: usually seen in post-menopausal women
Eye redness
- Allergic rhinitis: hay fever due to allergies
- Conjunctivitis (pinkeye): itching and redness of the eye due to infection or allergy
- Corneal deterioration or infection: disease of the layer of tissues covering the iris and pupil
- Cluster headache: an extremely painful but uncommon type of migraine headache
- Glaucoma: increased pressure of the fluid within the eye with progressive blindness
- Scleritis and episcleritis: inflammation of the sclera, the white part of the eye
- Uveitis and iritis: inflammation of the uvea, a group of structures in the eye that includes the iris
Eye tearing or watering
- Common cold: a viral infection of the lining of the nose, throat, and large airways
- Conjunctivitis (pinkeye): itching and redness of the eye due to infection or allergy
- Corneal infection: disease of the layer of tissues covering the iris and pupil
- Entropion/ectropion: inward- or outward-turning of the eyelid
- Scleritis and episcleritis: inflammation of the sclera, the white part of the eye
- Uveitis and iritis: inflammation of the uvea, a group of structures in the eye that includes the iris
- Blocked tear duct
- Dry eyes
Diagnostic Procedures
If you have a persistent eye infection, your doctor may perform an eye culture to find out what organism(s) are causing the infection, so he or she can precisely tailor an antibiotic regimen. Though eye tumors are rare, diagnostic imaging such as CT and MRI scans can determine, without surgical intervention, if there are abnormal growths within or around the eye.
Goals of Treatment
Relieving the discomfort and redness of an irritated eye is important, but it should not overshadow the need to resolve the underlying problem. You may be tempted to use eye drops such as Visine to "get the red out." However, such eye drops contain vasoconstrictors-- chemicals that temporarily constrict the blood vessels of your eye. Once you discontinue such medications, your eyes may become even redder. Consider using artificial tears rather than eye drops that contain vasoconstrictors.
If you do have bacterial conjunctivitis, your doctor may prescribe an antibiotic eye drop for you and recommend using warm or cool compresses on your eyes. Usually, the infection will end in one to two weeks. Viral conjunctivitis is very contagious. Prescription medications are also available for the relief of seasonal, allergy-related eye irritation. Your doctor may recommend cold compresses to help relieve the symptoms of allergic conjunctivitis.
Treatment Options
Drugs most commonly used
- Tobramycin or gentamicin: for bacterial conjunctivitis
- Sulfacetamide: for bacterial conjunctivitis
- Erythromycin ophthalmic ointment: for bacterial conjunctivitis
- Lodoxamide tromethamine: for vernal (springtime) conjunctivitis
Supplements
- Antioxidants: oxidative damage causes many serious eye problems, including cataracts and macular degeneration. Antioxidant nutrients help prevent them and keep the eye working properly. Try a daily dose of 2,000 mg of vitamin C, 25,000 IU of mixed carotenoids (the vitamin A family of nutrients, including beta-carotene), 400 to 800 IU of vitamin E, and 200 micrograms (mcg) of selenium.
Preventing Eye Irritation
Viral or bacterial conjunctivitis (pinkeye) is highly contagious, but you can avoid it. Wash your hands frequently to help prevent your eyes from becoming infected or infecting someone else. Avoid touching the infected eye(s). If you have to touch your eye, wash your hands. Do not share washcloths or towels that are used for drying hands with other people.
It is important not to contaminate bottles of eye medication by allowing them to come in contact with the eyelid. Also, if you wear contact lenses, ask your doctor whether you should stop wearing your contact lenses for awhile. Contact lenses can spread infection from one eye to the other, and you should thoroughly disinfect them if worn in an infected eye. Discard old eye makeup and avoid using replacements until the infection is gone.
You can minimize allergic conjunctivitis by avoiding the offending agents, such as grass or chemicals.
Self-Care Measures
- Keep blinking. Neglecting to do so is a main cause of eye irritation among computer users. Blinking washes, hydrates, and lubricates the eye. Computer screens have a subtle hypnotic effect that suppresses blinking, so computer users are at risk for dry, irritated eyes. Look away from your screen frequently and blink.
- Get enough sleep. Most people need at least seven hours a night. Many need eight or more.
- Follow your doctor's advice. The best help you can give yourself is to carefully stick to the regimen your doctor prescribes. Do your best to create a sterile environment to minimize the chances of infecting or reinfecting your eyes. If you are given an antibiotic drop or ointment, take it as directed. Avoid using eye drops with vasoconstrictors, as these only disguise the degree of your eye problem. Most importantly, seek the aid of your ophthalmologist if your eyes do not improve after three days. Early medical treatment is important in overcoming infectious eye problems.
Seek Medical Attention
If eye irritation persists for more than three days and is unrelieved by artificial tears, consult your doctor.
Websites & Organizations
American Academy of Ophthalmology
P.O. Box 7424
San Francisco, CA 94120-7424
Phone: 415-561-8500
American Allergy Association
P.O. Box 7273
Menlo Park, CA 94026
Phone: 650-322-1663
American College of Rheumatology
1800 Century Place, Suite 250
Atlanta, GA 30345
Phone: 404-633-3777
Fax: 404-633-1870
www.rheumatology.org
American Optometric Association
243 Lindbergh Boulevard
St. Louis, MO 63141
Phone: 314-991-4100
Email: AmOptCCC@aol.com
www.aoanet.org
Glaucoma Foundation
33 Maiden Lane
New York, NY 10038
Phone: 800-452-8266
Email: glaucomafdn@mindspring.com
www.glaucoma-foundation.org
The Lighthouse Inc.
111 East 59th St.
New York, NY 10022
Phone: 212-467-9200 or 800-232-5497
National Eye Health Education Program
2020 Vision Place
Bethesda, MD 20892-3655
Phone: 301-496-5248
www.nei.nih.gov
Sources & Further Reading
Books
Balch, James F. and Balch, Phyllis A. Prescription for Nutritional Healing. Garden City Park, NY: Avery Publishing, 1997.
Fauci, Anthony J., et. al. Harrison's Principles of Internal Medicine, eds. New York: McGraw-Hill, 1998.
Hardman, Joel G. and Limbird, Lee E. Goodman and Gilman's The Pharmacological Basis of Therapeutics eds. New York: McGraw Hill, 1996.
Murray, Michael T. Encyclopedia of Natural Medicine. Prima, 1998.
Noble, John. Primary Care Medicine ed. St. Louis: Mosby, 1996.
Physicians' Desk Reference. Montvale, NJ: Medical Economics Co., 1998.
Tierney, LM, McPhee, SJ, and Papadakis, MA. Current Medical Diagnosis and Treatment ds. Stamford, CT: Appleton & Lange, 1998.
Articles
Cometto-Muniz, JE, Cain, WS, Hudnell, HK. "Agonistic Sensory Effects of Airborne Chemicals in Mixtures: Odor, Nasal Pungency, and Eye Irritation." Percept Psychophys. 59(5):665-74. Jul 1997.
Cot'e, R, Davis, H, Dimock, C, Korpan, M, Loewen, K, Segal, LM. "The Evaluation and Hazard Classification of Toxicological Information for Workplace Hazardous Materials Information System Material Safety Data Sheets." Regul Toxicol Pharmacol. 27(1 Pt 1):61-74. Feb 1998.
Hoppe, P, Praml, G, Rabe, G, Lindner, J, Fruhmann, G, Kessel, R. " Environmental Ozone Field Study on Pulmonary and Subjective Responses of Assumed Risk Groups." Environ Res. 71(2):109-21. Nov 1995.
Jinot, J, Bayard, S. "Respiratory Health Effects of Exposure to Environmental Tobacco Smoke." Rev Environ Health. 11(3):89-100. Jul-Sep 1996.
Longman, LP, Higham SM, Bucknall R, Kaye SB, Edgar WM, Field EA. "Signs and Symptoms in Patients with Salivary Gland Hypofunction." Postgrad Med J. 73(856):93-7. Feb 1997.
Poulsen, OM, Breum, NO, Ebbehoj, N, Hansen, AM, Ivens, UI, van Lelieveld D, Malmros, P, Matthiasen, L, Nielsen, BH, Nielsen, EM, et al. "Sorting and Recycling of Domestic Waste. Review of Occupational Health Problems and their Possible Causes." Sci Total Environ. 168(1):33-56. May 19, 1995.
Purser, D. "Behavioural Impairment in Smoke Environments." Toxicology. 115(1-3):25-40. Dec 31, 1996.
Sakol, PJ. "Tearing: Lacrimal Obstructions." Pa Med. 99 Suppl():99-104. Mar 1996.
Schenker, MB, Jacobs, JA. "Respiratory Effects of Organic Solvent Exposure." Tuber Lung Dis. 77(1):4-18. Feb 1996.
Soine, L. "Sick Building Syndrome and Gender Bias: Imperiling Women's Health." Soc Work Health Care. 20(3):51-65. 1995.