Why Are My Eyes Always Red?

It seems like your eyes are always red, and people are starting to notice. (Side-eye, much?) You left the all-nighters and partying back in your college days, so what gives? Ophthalmologist Catherine Hwang, MD, brings into focus the possible causes of your bloodshot eyes — and when you should see an eye doctor.

What causes red eyes: No big deal edition

Allergies

• The clues: Check the calendar, and if it’s pollen season, you may have your answer. Your eyes may also be itchy, watery or feel like they are burning. Are you sneezing or stuffy, too? Then checkmate.
• Should you see a doctor? See an allergist or ophthalmologist if you don’t know the cause of your symptoms or if you suspect allergies but aren’t sure.
• Treatments: Prescription and over-the-counter (OTC) eye drops, allergy pills and nasal sprays.

Broken blood vessels

• The clues: “Most people don’t even notice them. Their friends or family members notice, and it’s usually right after the person wakes up,” Dr. Hwang relates. “It’s like a little bruise on the eye. And it often appears worse before it gets better.”
• Should you see a doctor? Not unless it’s associated with pain or vision changes. If it is, “You have to go right to an eye doctor. Do not pass Go. Do not collect $200.”
• Treatments: Good news! Broken blood vessels usually clear up on their own. So sit tight and wait it out.

Dry eyes

• The clues: Not only are those peepers red, but it feels like there’s sand in them. The sensation can feel worse at night.
• Should you see a doctor? If it’s not getting better with OTC lubricating drops, see an ophthalmologist.
• Treatments: OTC eye drops or artificial tears, prescription eye drops and punctal plugs. Dr. Hwang explains punctal plugs: “Everyone has a tear drainage system on the inside corner of the eyes. Just like you plug up a sink to keep the water in, sometimes we put a ‘plug’ in the eye to help your natural tears stay around longer.”
• A note on potential dry eye causes: Anything that fatigues your eyes — such as too much screen time or not enough sleep — can make them overly dry.

Eye irritation

• The clues: The windows to your soul may feel a little cloudy. Or maybe you came into contact with a bug on a suicide mission. Whatever happened, something feels off or irritated.
• Should you see a doctor? If you wear contacts, yes. It could be an eye infection. “We want to treat those infections quickly,” notes Dr. Hwang. “Otherwise, it can turn into a bad ulcer.”Also see an eye doctor if there is pain associated with the irritation or it doesn’t get better within a day.
• Treatments: It depends on the cause of the irritation.

Pink eye (conjunctivitis)

• The clues: In addition to a pink eye (duh!), your eye has a burning sensation or feels itchy. It may also swell or have discharge.
• Should you see a doctor? Definitely.
• Treatments: If it’s viral, doctors only treat your symptoms until the infection clears up on its own. Symptom relievers include cold compresses and artificial tears to soothe the eye surface. If it’s bacterial, doctors prescribe antibiotic drops. “But it’s rarely bacterial,” Dr. Hwang says.
• Pink eye precautions: Conjunctivitis is highly contagious, so avoid sharing towels, linens or anything that comes into contact with your eye.

When red eyes attack: See an eye doctor edition

Dr. Hwang emphasizes when in doubt, get it checked out. “Since most of these symptoms are similar, it’s important to see an eye doctor who can distinguish between what’s concerning and what’s not.”

Go the “better safe than sorry route” if you experience one or more of these symptoms along with bloodshot eyes:

• Eyes that are beet red.
• Redness in just one eye.
• Swelling or redness on the eyelid.
• Eye pain.
• Unexplained changes in vision or sensitivity to light.

Eye condition spotlight: Uveitis

Uveitis is inflammation in the eye’s iris and lining. It can cause red eyes, light sensitivity and pain. Left unchecked, uveitis can lead to eye conditions such as glaucoma, cataracts or even blindness. While prescription eye drops often clear it up, your eye doctor may need to run tests to find out what’s causing it.

Eye condition spotlight: Eye tumor

Rarely, there can be tumors in the eye or on the surface of the eye. They can be tricky to spot on your own, especially since you may not experience symptoms. If you have unexplained eye irritation or vision changes, see an ophthalmologist right away.

A word of caution: Just say no to eye drops marketed as “redness relievers”

Dr. Hwang says they may:

1. Mask issues you should get checked out.
2. Make the eyes drier and more irritated.
3. Cause rebound redness, or rebound hyperemia.

These drops work by shrinking the blood vessels on the surface of the eyes and reducing the blood flow to them. But less blood flow means less oxygen and nutrients, too. So when you stop using the drops, the blood vessels get even bigger to make up the difference. You’ll end up with eyes that are redder than before.