Red Eye: Comprehensive Guide
Definition
Red eye refers to a condition where the eye appears red due to the dilation or rupture of blood vessels in the conjunctiva (the transparent layer covering the white part of the eye). It is often associated with irritation, infection, or other underlying medical conditions.
Causes
Red eye can result from various causes, broadly categorized as infectious and non-infectious:
Infectious Causes:
- Conjunctivitis (Pink Eye): Bacterial, viral, or allergic inflammation of the conjunctiva.
- Keratitis: Infection or inflammation of the cornea.
- Uveitis: Inflammation of the uvea (middle layer of the eye).
- Endophthalmitis: Severe infection inside the eyeball, usually after surgery or trauma.
Non-Infectious Causes:
- Allergies: Reaction to allergens like pollen, dust, or pet dander.
- Dry Eye Syndrome: Insufficient tear production leading to irritation.
- Subconjunctival Hemorrhage: A burst blood vessel causing a localized red patch.
- Trauma or Injury: Physical damage to the eye or foreign body irritation.
- Glaucoma: Increased intraocular pressure leading to redness and pain.
- Contact Lens Overuse: Prolonged wear of lenses without proper cleaning or care.
Signs and Symptoms
The symptoms accompanying red eye depend on the underlying cause:
- Redness (generalized or localized)
- Pain or discomfort
- Itching or burning sensation
- Excessive tearing or watery eyes
- Discharge (watery, mucous, or purulent)
- Sensitivity to light (photophobia)
- Blurred vision
- Swelling of eyelids or conjunctiva
- Foreign body sensation
Diagnosis
A detailed medical history and thorough eye examination are crucial for diagnosing the cause of red eye. Key diagnostic steps include:
- History Taking: Enquire about onset, duration, associated symptoms, and potential exposure to allergens or infections.
- Visual Acuity Test: Assess vision clarity.
- Slit-Lamp Examination: Examine the eye structures under magnification.
- Fundoscopy: Evaluate the retina and optic nerve.
- Intraocular Pressure Measurement: Check for glaucoma.
Investigations
Further investigations may be required based on clinical findings:
- Swab and Culture: Identify bacterial or fungal infections.
- Fluorescein Staining: Detect corneal abrasions or ulcers.
- Complete Blood Count (CBC): Assess for systemic infections.
- Allergy Testing: Determine specific allergens.
- Imaging: CT or MRI in cases of suspected orbital cellulitis or trauma.
Treatment
The treatment of red eye depends on the underlying cause:
General Measures:
- Rest the eyes and avoid irritants (e.g., smoke, allergens).
- Apply cold or warm compresses as appropriate.
- Maintain proper hygiene, especially if infectious.
Medications:
- Conjunctivitis:
- Bacterial: Antibiotic drops (e.g., Tobramycin, Moxifloxacin).
- Viral: Supportive care; artificial tears; Acyclovir for severe herpetic infections.
- Allergic: Antihistamine drops (e.g., Olopatadine, Ketotifen).
- Keratitis:
- Bacterial: Intensive antibiotics (e.g., Ciprofloxacin drops).
- Fungal: Antifungal drops (e.g., Natamycin).
- Viral: Antiviral drops (e.g., Ganciclovir).
- Uveitis: Corticosteroid drops (e.g., Prednisolone Acetate) and cycloplegic agents (e.g., Atropine).
- Glaucoma: Medications to reduce intraocular pressure (e.g., Timolol, Latanoprost).
- Dry Eye Syndrome: Artificial tears and lubricants.
- Subconjunctival Hemorrhage: Usually resolves on its own; no treatment required.
Surgical Interventions:
- Drainage or repair in severe infections, trauma, or complications like corneal ulcers.
- Laser or surgical treatment for glaucoma.
Complications
If untreated, red eye can lead to:
- Vision loss
- Corneal scarring
- Spread of infection (e.g., orbital cellulitis)
- Chronic dry eye
- Increased intraocular pressure (glaucoma)
Management
Preventive Measures:
- Avoid rubbing eyes.
- Use protective eyewear during activities prone to eye injury.
- Ensure proper contact lens hygiene.
Follow-Up Care:
- Regular eye check-ups for recurrent or chronic conditions.
- Monitor intraocular pressure in glaucoma patients.
Patient Education:
- Emphasize the importance of completing prescribed treatments.
- Discuss potential triggers and how to avoid them.
By understanding the causes and adopting early treatment, red eye can be effectively managed, preventing complications and ensuring optimal eye health.