Other reasons your eyes might be red

The eyes can become red for many reasons. Often, the redness goes away without treatment. Sometimes, however, red eyes can be a symptom or a more serious condition. Some causes of red eyes can even lead to vision loss.

Red or bloodshot eyes occur when small blood vessels on the surface of the eye become enlarged and congested with blood. Red eyes alone are not usually a reason for concern. However, if there is also eye pain, watering, dryness, or impaired vision, this can indicate a serious medical problem.

Infective conjunctivitis 

The red eye infection broke out in schools around Kampala on March 14 this year and the cases are said to have risen to 7,500 by April 6, according to the Ministry of Health. The cases were reported in Kampala, Arua, Mbale and Kagadi.

According to the ministry, the highest risk of spreading or contracting the contagious disease are in places of congregate settings such as schools, churches, arcades, and markets, among others.

While these red eye infections are caused by a virus, other causes of red eyes can be bacterial or fungal or after an injury.  The causes of red eye range from a minor irritation to a more serious condition or infection, including conjunctivitis and corneal ulcers, says Dr Sheila Njuki, an ophthalmologist at Mildmay Hospital in Kampala.

“Red eyes, also known as conjunctivitis, is when the white part of the eye becomes red and swollen. It could be due to a virus or bacteria. It is very common, especially among children but can also affect adults, and is usually contagious,” DrNjuki says.

Some signs and symptoms of conjunctivitis include redness, itchy eye, excess tear production, sensitivity to light, discharge and a gritty feeling in one or both eyes and poor vision. 

The infection commonly spreads through direct contact with contaminated fingers or personal items. It can be associated with an upper respiratory infection, and people can pass it on through coughing.

The infection usually affects both eyes because it typically spreads from one eye to the other.

“When one has red eyes, it is important that they seek medical attention and from the hospital, the health worker will be able to diagnose red eye by looking at the symptoms and assessing the type of discharge present,” Dr Njuki says. 

Bacterial conjunctivitis

Dr Franklin Wasswa, a consultant oculist, says different from the viral conjunctivitis, bacterial conjunctivitis presents with an often white discharge, green, or yellow such as pus. 

He adds that treatment options for conjunctivitis depend on the cause. Viral conjunctivitis can go away without treatment and does not typically cause any long-term problems. Bacterial conjunctivitis, however, if left untreated can cause blindness.

To avoid the spread of conjunctivitis, he advises frequently washing one’s hands as well as avoiding rubbing the eyes, sharing eye drops, cosmetics, towels, or pillowcases.

After conjunctivitis clears, a person should dispose of any contact lenses, solutions, or eye makeup they used during the infection to help prevent reinfection.

Subconjunctival haemorrhage

The conjunctiva contains many blood vessels and capillaries. Sometimes, these vessels break and leak into the area between the conjunctiva and the white of the eye.

When this happens, a small amount of blood builds up under the conjunctiva, causing a subconjunctival hemorrhage. This minor bleeding under the eye’s outer membrane causes bright red spots to appear on the white of the eye.

A subconjunctival haemorrhage can result from a minor injury or trauma to the eye, including rubbing the eye due to allergies.

Common causes include coughing, sneezing and straining. People who have diabetes, high blood pressure, or take certain medications, such as blood thinners, may have a higher risk of suffering from this condition.

Subconjunctival haemorrhages occur on the surface of the eye but do not affect the cornea or the interior of the eye. They also do not impact vision.

“They are not usually painful and the only symptoms may be red spots in the white of the eye. Although redness or blood in the eye can look serious, most subconjunctival hemorrhages are generally harmless and will clear up on their own within a few days,” Dr Njuki says.

Allergies

Allergic conjunctivitis can develop due to an allergy or an irritant such as dust, pollen, or animal waste. Contact lenses and lens solution may also trigger an allergic reaction. In addition, if a person wears contact lenses for too long, conjunctivitis can arise due to irritation. Conjunctivitis due to allergies or irritants is not contagious.

Dry eyes

A person whose body does not produce adequate tears to lubricate and nourish the eyes may develop dry eye syndrome. The tears may sometimes not have the texture they should, might evaporate too fast or someone may not make tears at all. This is known as dry eye syndrome and causes pain and ulcers on the cornea but can also cause vision loss although in rare cases.

Hormonal changes, some medical conditions, and some medications can cause dry eye syndrome. Chronic dry eye can cause the surface of the eye to become red, inflamed, and irritated.

Dr Wasswa says, “Symptoms of red eye symptoms include a feeling that something is in the eye, pain and redness in the eye, eye fatigue, stinging or burning eyes, discomfort when wearing contact lenses, blurry vision, and discomfort after watching television or reading.”

Depending on the severity of the problem, dry eyes can be treated with over the counter medications such as gels, eye drops, ointments, artificial tears and even surgery. 

Corneal ulcers

A corneal ulcer is an open sore on the cornea that can result from a bacterial, viral, fungal, or parasitic infection. It can be related to sleeping in contact lenses, scratches, burns or dry eye syndrome. Conditions that affect eyelid function can also increase the risk of these ulcers.

Contact lenses can rub against the eye’s surface and slightly damage the outer cells. This damage may allow pathogens such as bacteria to penetrate the eye, causing corneal ulcers.

It manifests with symptoms such as sensitivity to light, red eyes, pain or soreness, mild-to-severe eye discharge, reduced vision.

“Corneal ulcers are a medical emergency because without appropriate treatment, they can lead to loss of sight. Treatment options include antibiotics and antifungal agents. Serious cases may require a cornea transplant,” says Dr Wasswa.