Lifestyle Health

Thursday 22 March 2018

What can I do about my itchy, irritated eyes?

Dr Nina Byrnes

My eyes are bothering me lately; they get red and itchy and the eyelids are also inflamed. My doctor has prescribed ointment that helps but I don't want to keep using this. What can I do?

RED eye is one of the most common eye complaints that people attend their doctor with. There are many causes. Most are more irritating than harmful but a few may be serious so it is worth having it looked at. The red colouring of the eye occurs when blood vessels on the surface of the eye expand due to inflammation.

A red eye may be due to an infection of the eye (conjunctivitis), inflammation of the eye lids (blepharitis), allergies or hay fever, something in the eye that is irritating it, burst blood vessels, scratches or damage to the surface of the eye, inflammation of parts of the eye, glaucoma and dry eyes.

Less serious causes of red eye tend to cause a gritty, irritating sensation along with possible discharge from the eye or along the lids, itch or irritation. If a red eye is associated with pain or your vision is affected, it is important to seek urgent specialist medical review.

Conjunctivitis is one of the most common causes of red eyes and it results in a red, irritated, gritty eye with or without discharge. Most people assume that conjunctivitis is due to a bacterial infection and that an antibiotic is required but this is not always the case. Viral and allergic conjunctivitis are also very common and may appear very similar.

A bacterial infection will often start in one eye and may spread to the other. In the case of a virus or allergy, both eyes may be affected from the start. If both eyes become red and irritated, and especially if you have any other symptoms of a viral infection or hay fever, it is worth bathing the eye regularly or taking an antihistamine for a few days. An antibiotic may not be required.

However, if discharge is thick and coloured or the eye is not improving after two to three days, other medication may be necessary. Both bacterial and viral conjunctivitis are highly contagious. If you use make-up, it is important to clean your brushes and change your mascara regularly.

Blepharitis is inflammation of the eyelids. It results in irritation, itching and redness. The surface of the eye itself is often only mildly affected or may not be red at all. Blepharitis tends to be a chronic condition that can come and go. Keeping it at bay requires regular care and maintenance. Bathing eyes twice daily by adding a small drop of baby shampoo to cooled boiled water helps remove oily residue. I advise cleansing the eyelids as if you were trying to remove mascara, using clean cotton wool for each eye. An antibiotic ointment may be required if the lids have flared, and using drops to avoid dry eyes can also help.

A subconjunctival haemorrhage occurs when a small blood vessel breaks and bleeds on the white surface of the eye. They are painless and often appear without warning but can look quite dramatic. They can be caused simply by coughing or sneezing forcefully or in rarer cases high blood pressure. Apart from having a blood pressure check, no treatment is required and they settle spontaneously.

It sounds like you may be having repeated episodes of blepharitis and conjunctivitis. Bathing your eyes regularly in between episodes may help reduce the frequency of these. However, you may occasionally require treatment so if the redness is persistent it is worth visiting the doctor. Conjunctivitis and blepharitis are painless causes of a red eye. If you have a painful red eye you should see the doctor straight away.

No conversation about red eye would be complete without mentioning Glaucoma. It may or may not cause a red eye or pain.

There are two main types. The chronic form progresses slowly and does not cause pain so vision may deteriorate significantly before a diagnosis is made. Symptoms of acute glaucoma include a red, severely painful eye, nausea and vomiting, blurring of vision and halos around lights. Chronic glaucoma may only cause a painless gradual loss of peripheral vision.

Both conditions result in a build-up of fluid and pressure within the eye, ultimately damaging the optic nerve and vision. If glaucoma isn't treated, vision may be permanently damaged. This condition is most common in those over 60.

A family history, near-sightedness, medical conditions such as diabetes and thyroid disease, or previous eye problems also increase the risk. Glaucoma tests are recommended once in your twenties, twice in your thirties, every two years from aged 40 to 64, and every year after that.

If you have any risk factors, eye checks should occur more frequently. Glaucoma tests are usually offered by the optician as part of a routine eye check.

Irish Independent

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