What to do if you have red eyes

This depends on what is the cause of your red eyes. I always ask my patients the following questions to help identify the cause. 

Do you have pain or irritation in the eye? 

Do you have an obvious amount of discharge in the eyelids when you open your eye in the morning? 

Do you feel swollen or pressure inside your eye?

Are you experiencing any change of vision right now?

If the answer is yes to one or more of the above, then you would need to be assessed by a pharmacist or a physician for potential eye infection or irritation from chemicals.  

If the answer to all of the above is no. But the patient complains there is a feeling of “a small sand scratching the eye”. This can be caused by benign reasons such as inverted eyelashes, mild scratches caused by dust, makeup brushes, severe dry eye, or even rubbing the eye. Then there is no damage to the eye.  In this case, all that is needed is an eye lubricant.

Sometimes patients will mention there is no abnormal feeling at all, until when looking into the mirror and realize there are red patches on the surface of the eyeball. This is a result of the bursting of microcapillaries on the surface of the eye which can be caused by sneezing, lifting heavy stuff, or eye rubbing. This can also be easily relieved by eye lubricant.

When choosing an eye lubricant to relieve dry eyes or mild irritation due to reasons from above, it is important to avoid products with ingredients such as nephazoline, oxymetazoline, and tetrahydrozoline. These ingredients belong to a drug class called vasoconstrictor. While they are very effective in reducing redness and allergy symptoms by constricting blood vessels in the eyes. They can cause rebound redness if used for more than 3 days in a row, making eye redness worse. Also they can increase eye pressure which can worsen the severity of glaucoma.