Your eyes are generally white when the vitreous humor is unaffected by other factors. However, should you suffer a blow to the eye or suffer an eye condition, redness is possible. That should not be a cause for much worry unless the redness comes with pain.
In this case, you should talk to your doctor to figure out the underlying cause. This article will delve into possible conditions that could cause the eye redness with pain:
Possible causes of eye redness with pain
Conjunctivitis
Conjunctivitis also goes by the name pinkeye and often affects children aged five and below. That is not to say that it does not affect people above this age gap, as they are also at risk of getting it. It comes about when the eyeball covering and inside of the eyelid get inflamed. This disease can result from many triggers, among them bacterial and viral infections, and allergic reactions.
For bacterial infections, patients experience yellow mucus discharge from their eyes. Timely treatment using drops and ointments allows patients to get alleviation in a few days. You can leave the condition untreated, which is not advisable, and it would clear within two weeks.
Viral infections, on the other hand, can come about owing to a cold or otherwise. They do not have as much yellow mucus discharge as bacterial infections. In some cases, they may cause tearing. There is no treatment for these, but your doctor may give you something to alleviate the symptoms. The infections usually pass within ten days or so.
The other form of conjunctivitis occurs as a result of exposure to allergens. Irritants include but are not limited to drugs, pollen, smoke, and other such elements in the atmosphere. Allergies can come about in many forms, including seasonal and perennial allergies.
Patients experience tearing, redness, and itching, among other symptoms. For this, your doctor will recommend eye drops, antihistamines, mast cell stabilizers, and other drugs to reduce the inflammation.
In this article, we will focus on pink eye resulting from infections and what you can do about this.
Conjunctivitis symptoms
People with conjunctivitis experience a change in the color of the white part of their eyes. They can turn pink or red, hence the name pink eye. It owes to inflammation of the eyelid and causes symptoms such as redness, itchiness, tearing, and swelling. You may experience one or more of these symptoms when you have inflammation.
Some people also get a discharge that makes their eyes sticky. You probably know what it feels like to wake up with your eyes shut tight owing to pus. People who have had pink eye at some point in their lives can relate.
You can deal with this by applying some warm water to the crusts along the eyelids to loosen them. You should be careful when doing this to prevent further aggravating the sensitive lid.
Other symptoms include eye pain, grittiness in the eyes as well as sensitivity to light. Symptoms generally appear one to three days after infection and can be in one eye.
Should you worry?
Waking up with your eyes sealed shut can be a scary experience. It gets even worse when you notice a change in eye color. Well, the thing is, pink eye is a common eye condition. Unless the doctor says otherwise, there is no cause for worry. In seven to ten days, you should experience some alleviation in symptoms.
In some cases, the infection is pretty mild, and you can do without any medication. Note that you can only disregard drugs with the go-ahead from your doctor.
For some people, the condition requires urgent treatment owing to the severity of the infection. If you notice that the symptoms are not getting better or are worsening, you should consult your doctor. They can check if anything is out of the norm and prescribe drugs for your case.
Using over the counter drugs is not advisable as the symptoms could be an indication of another eye condition.
In the case of children, you should not take any chances. Take the child to the hospital and follow the advice of the doctor. Your child may have to stay home for a while as the inflammation clears.
Where you are using antibiotics, you must finish the recommended dose. Failure to do so can lead to a flare-up of the pink eye again, maybe even in more severity.
contagiousness of conjunctivitis
How can you get pink eye? You wake up in the morning with crusts along your eyelid, and you wonder how this happened. Unless you have allergies, the cause points to a bacterial or viral infection. If you have interacted with someone with pink eye, the chances are high that you can get it.
This disease spreads very quickly. It takes one person in the family to have it, and from there, it spreads like wildfire. How? There is discharge coming from your eye. If you touch your eyes and touch another person, you can spread this pus. Then they touch their eyes, and they, too, get infected. You know how often people touch their faces. It quickly becomes a cycle.
Sometimes, you do not have to touch people to spread the infection. All you have to do is to touch a common surface such as a towel with the infected eye. Someone else will touch the towel and transfer the discharge to their face. Just like that, you have spread the infection.
Coughing and sneezing are other modes of infection common when the inflammation owes to viral infection.
Conjunctivitis prevention
As you can see, there are many ways you could end up spreading the infection. And when you do so, your chances of healing reduce. Take an example of where you have a roommate. You get the infection from work and take it home. Then your roommate gets it after touching your items. You heal, then your roommate infects you. Then the cycle starts again. How can you ensure that you and other people are safe from pink eye?
It all comes down to hygiene practices, which you should follow strictly. These guidelines are essential from the day of the onset of the inflammation until it clears. You can stop following them when the redness goes away.
Washing your Hands: It may look basic, but it would surprise you how many people don’t wash their hands as needed. And when they do, they use plain water to do so. Washing your hands is essential.
That way, if you have touched an infected surface or the inflamed eye, you can wash away the pus. It ensures that you do not contribute to spreading the discharge to other surfaces. Use warm water and soap to do this every time you touch the infected eye.
Not Rubbing the Infected Eye: the infected eye is likely to be itchy, and this might have you feeling like scratching it. Doing this can aggravate the inflammation, making it last longer than it is necessary. If you feel like rubbing on the eye, will yourself not to do it.
Try as much as possible to avoid touching the infected eye. Anytime you do, wash your hands with warm water and soap. If you are looking after an infected person, you should practice frequent hand washing. In some cases, the infection may be in one eye. Where this is the case, work on preventing the spread of the infection to the other eye.
Clean the Discharge: infected eyes will release pus throughout the day. It will not be much but is enough to cause the shutting of the eye and formation of crusts. You should clean this pus twice a day to prevent this. Start at the nose side and move towards the outer part of the face using a tissue wipe. Doing this ensures that you do not touch the uninfected eye. Finish up by washing your hands as recommended.
Avoid Washcloths: you will notice that in cleaning the pus, the advisable material is a facial wipe. Why is this? Your facecloths and towels likely have the infecting agent. That way, you would only be compounding the problem. Facial wipes are one-use and cannot have the microorganisms causing the inflammation.
Where you cannot get facial wipes, you should use towels that do not belong to the infected person. After that, you can work on disinfecting them to ensure they do not carry bacteria or viruses.
Separate Laundry: anything used by the infected person is likely to carry discharge that could infect others. If you live alone, you can wash your clothes in one cycle. But where you live with others, you should separate your laundry from theirs. Make sure you disinfect your clothes by using detergent and hot water. Keep up with this separation until the doctor clears you of pink eye.
Avoid Irritants: contact lenses and makeup will only make the inflammation worse. Also, they could be a source of infection-causing microorganisms. Thus, you should work on cleaning any lens you had prior used in your eyes. Avoid wearing them until the inflammation clears. As for makeup, you should throw away everything you have been using to the point of inflammation. Using it would only re-introduce the disease-causing micro-organisms.
With these preventative measures, you can completely heal from the pink eye and protect those around you. You have to be extra careful with children as they may not understand the need for all these measures.
Conjunctivitis treatment
Usually, pink eye clears on its own, without a need for medical intervention. However, this decision is not up to you, but rather a licensed eye doctor. Once you notice any symptoms, you should book a consultation with your doctor. They will decide if you need drugs or not.
If you do, they are likely to prescribe eye drops or ointment where you have a bacterial infection. Viral infections do not have specific treatments, but the doctor could offer you some drugs for alleviation.
Hand-washing is essential when handling eye drops and ointments. These, too, could be a source of disease-causing micro-organisms.
Using eye drops for conjunctivitis
While eye drops work in reducing the inflammation in your eyes, they could also contribute to inflaming them. ‘How?’ you ask. Well, if the dropper is not clean, it could transfer micro-organisms to your eyes, aggravating them. It is thus essential that you follow some guidelines:
Clean the dropper: ensure that the dropper is clean any time you wish to administer eye drops to your eyes. Clean it, and do not touch it with your hands if you have not thoroughly washed them.
Avoid Contact: as you administer eye drops, you need to ensure there is a gap between the dropper and the eye. You should not touch any eye part or any other surface using the dropper. That would transfer the infectious organisms. After that, you would be transferring microorganisms to the infected eye. Once you finish administering the drops, you should return the dropper to the bottle. That way, you can avoid any unnecessary contact.
Tug on the lid: using eye drops can be a bit unnerving. You might find yourself blinking as the drop enters the eye. The result is wasted eye drops. To avoid this, tug on the lower eyelid, as this makes it hard for you to close your eyes. You will end up getting more drops into your eyes. If you feel some type of way after administering the drops, it could be that the eyes are very sensitive. You can try targeting the white part as this is less sensitive. If this does not help, talk to your doctor.
Avoid Shaking: if your hands tremble during the application, you will need to steady them. You can do this by resting them on the forehead or nose bridge as you lie on your back.
Easy Does It: while you may want to get it over and done with, you need to pace yourself when using eye drops. Start with one drop and allow the eye to rest and absorb the drug. Shut your eye for a few minutes, or as recommended by the doctor, before using another drop. You should keep the drops in the fridge. That way, you can tell when you have hit the eyeball based on the coolness you feel.
Using Ointment
Using ointment directly on the eyeball is quite a hard task. Not many people are up for it. Instead, you can apply the ointment on your eyelashes. Over time, it melts and enters the eye, offering you some relief.
Uveitis
The eye has many layers, one of them being the uvea. When this layer gets inflamed, you suffer from a condition known as uveitis. It can affect one or both eyes and can either be short term or long term.
Usually, it occurs when the inflammation has spread through other parts of the body and the eye. It is a severe condition that can lead to vision loss if left untreated. That’s why you should always report any changes in your eyes to a licensed eye doctor.
That way, you can get a diagnosis at the onset of the disease and receive early treatment. Tens of thousands of blindness cases each year result from untreated eye inflammations. You can thus see how important it is to get early treatment.
What is the uvea? This layer of the eye comprises three parts, namely the iris, the ciliary body, and the choroid. The iris is the colored part of the eye that controls light entering the eye. It does so by controlling the size of the pupil. The ciliary body comprises muscles and blood vessels.
It works in focusing the eye as well as producing aqueous humor that fills the front part of the eye. The choroid lies to the back wall of the eye and has blood vessels. It feeds numerous eye parts, including the retina. Thus, an inflammation of the uvea would affect a significant part of your vision.
Often, when the uvea gets inflamed, the inflammation spreads to other parts of the eye. Often, they are the cornea, sclera, vitreous, optic nerve, and retina. The last part is critical in receiving light signals and processing images. The optic nerve sends messages from the eyes to the brain, making it quite essential to your vision.
Uveitis causes
What could cause an inflammation in the eye? Given the gravity of this condition, it would be best that you know what you should avoid.
Unfortunately, in about one-third of the reported cases, the cause of the condition is not clear. In the other two thirds, the causes point to surgery, eye infections, eye injuries, inflammatory disorders, and autoimmune diseases. These are but some of the likely causes.
Uveitis symptoms
How does inflammation of the uvea exhibit, and what signs should you be on the lookout for? Symptoms vary based on the kind of uveitis affecting the eyes. People with acute uveitis (short-term form) experience symptoms for six weeks or less. Those with long-term chronic conditions suffer symptoms for more than six weeks.
The symptoms may be present in one or both eyes, and they develop fast. They include eye redness, pain, light sensitivity, a blur in vision, floaters, and reduced vision. If you notice any of these symptoms, you should seek help from a licensed eye doctor immediately. They may or may not point to the presence of inflammation.
Are you at risk?
Who can get this disease, and who is at more risk than others? Well, uveitis is not selective when it comes to affecting people. You can thus get it regardless of your age and gender. However, it tends to affect people in their middle ages and women more than other people. Also, smokers are at more risk. That is not to say that you cannot get it because you do not fall into these risk groups.
Types of Uveitis
Earlier, we covered the parts of the uvea. When it comes to uveitis, doctors classify it based on the part of the uvea affected by the disease as follows:
Anterior Uveitis: as the name suggests, this condition affects the front part of the eye. In some cases, it goes by the name iritis, pointing to its effects around the iris. This condition is the most prevalent uveitis in children.
For adults, it accounts for 30-90% of the reported cases. It falls under acute uveitis, given that its symptoms show up fast and last for six weeks or less. People with this condition experience redness, pain, a blur in vision, and light sensitivity, among others.
In more than a third of the reported cases, the causes of this condition are unknown. But where the cause is clear, it could point to various conditions. They include lupus, herpes, inflammatory bowel disease, syphilis, reactive arthritis, and intraocular lens.
Other causes include psoriatic arthropathy, ankylosing spondylitis, sarcoidosis, Lyme disease, and Posner-Schlossman syndrome. These are but some of the causative factors. Only a thorough exam conducted by your doctor can confirm the cause.
Intermediate Uveitis: this condition inflames the ciliary body, the vitreous, and the front part of the retina. It also goes by other names such as vitritis, pars planitis, and cyclitis. It is the least common uveitis and accounts for less than 12% of the reported cases.
Patients experience floaters and blurred vision, accompanied with some redness. While pain might occur, it is not a primary symptom. Most people with this condition have chronic inflammation, and the symptoms last more than six weeks.
Unfortunately, pinpointing the cause of this inflammation is often hard. Only a third of the reported cases have a likely cause. The rest have unknown causes. You can get this disease where you have Lyme disease, multiple sclerosis, sarcoidosis, and other such conditions.
Posterior Uveitis: in this case, the inflammation affects the choroid and may spread to the optic nerve and retina. Other names for this disease include retinitis and choroiditis. It affects up to 5-30% of the reported uveitis cases and is thus quite common.
Unfortunately, it is a chronic condition that can last for weeks leading into months, which turn into years. In some cases, it is recurrent. That means that the affected eye goes through stages of health and inflammation.
Like other uveitis types, it can affect one or both eyes. Given its severity, this condition can lead to a loss in eyesight. Your doctor, upon a thorough eye examination, can confirm the presence of this inflammation.
The causes of this disease are often known, at least in almost 90% of the reported cases. Causative factors include toxoplasmosis, Epstein-Barr virus, acute retinal necrosis, sarcoidosis, lupus, and syphilis. Others include Behcet’s disease, serpiginous choroidopathy, cytomegalovirus retinitis, and birdshot retinochoroidopathy.
In some cases, the inflammation may point to acute posterior multifocal placoid pigment epitheliopathy.
Panuveitis: in the above cases, we have focused on inflammations that affect one part of the uvea. With Panuveitis, all parts of the uvea get inflamed, and this increases the chances of vision loss. It affects up to 10% of the reported cases. Affected people often experience floaters and a blur in vision.
The causes of this inflammation are often not clear. However, some conditions may put you at risk of developing it. They include lupus, syphilis, fungal retinitis, tuberculosis, sarcoidosis, Behcet’s disease, and other such conditions.
You should report any changes in eyesight to a licensed eye doctor for an accurate diagnosis. Diagnosis can be tricky where children are involved. They might not understand what is happening to their eyes, and they might not report the changes. This delay can lead to eye damage and vision loss. It is thus essential that you examine your children’s eyes often and assess their health.
Children are at risk of uveitis, though the causes are often unknown. It could be due to juvenile idiopathic arthritis, which is a leading cause. It could also owe to conditions such as chickenpox, reactive arthritis, lupus, toxocariasis, and acute retinal necrosis.
Uveitis diagnosis
Early diagnosis of uveitis paves the way for timely medical interventions. In this way, the likelihood of vision loss reduces. Note that delays in interventions could lead to eye damage, which can be irreversible in some cases. Also, the symptoms of uveitis may point to a severe condition. When left unmanaged, this condition could have devastating effects on the body.
The diagnosis of this condition follows a thorough examination by a licensed eye doctor. It starts with an eye exam where the doctor conducts the following tests:
Medical history: there is a strong relationship between uveitis and underlying health conditions. The doctor will assess the presence of other such conditions. It might be necessary that you undertake other tests to rule out the possibility of uveitis as a symptom.
Optic nerve test: have you ever had dilating eye drops used in your eyes? If not, this will the first time. The doctor will need to dilate your pupils so that they can see the optic nerve and check it during their assessment.
Visual test: inflammation of the eye can hurt your vision. The doctor will check the sharpness of your vision to check if there is a blur in the same. While at it, they will also check if your side vision is okay, assessing any damage to the optic nerve. The movement of your eyes will also be vital as it can point to any changes in the eyes.
Additionally, the doctor will assess the front of the eye, pressure, and the condition of the blood vessels. They will also take pictures of the retina during this process. Where there is a possibility that the inflammation owes to an infection, lab tests may be necessary. These are but some of the procedures used in confirming or ruling out the presence of uveitis.
Treatment of uveitis
Inflammation in the eyes can cause damage to the eyes. Thus, any treatment in place will work towards bringing down the inflammation and adding to the health of the eyes.
The medicines administered by the doctor also work in relieving the pain and preventing loss of vision. They also deal with any other complications brought on by the inflammation. Where the cause of the disease is clear, then the meds also work in treating this.
You must follow the instructions of your doctor to the letter if you wish to be free of inflammation. The treatment guidelines will remain in place until the inflammation clears. Here are possible treatment options based on the affected part of the uvea:
Anterior Uveitis: the doctor has numerous treatment options in this case as follows:
Topical Corticosteroids: these can be in the form of eye drops or ointments. These work best where the cause of the inflammation is known and requires urgent treatment. The topical meds work in bringing down the inflammation while other drugs work on the causative factor. They vary in intensity depending on the severity of the inflammation.
In some cases, the doctor may inject steroids into the eye. It happens when the eyes do not respond to topical meds. Very rarely, the doctor may administer steroid pills to the patient.
Dilating eye drops: during your eye exam, the doctor will use dilating eye drops to widen the pupil. They do this so that they can check the eye parts easily. If anterior uveitis is confirmed, the doctor can prescribe these eye drops. They work in widening the pupils such that the iris does not stick to the eye lens. Often, this is a complication of this disease.
Topical eye drops: sometimes, inflammation can increase eye pressure to a point where it can be damaging to the optic nerve. In this case, your doctor can prescribe eye drops to relieve this pressure.
Intermediate and Posterior Uveitis: the treatment courses are as follows:
Anti-Infective agents: where the disease is a result of an infection, these agents come in handy. They are effective in bringing down the inflammation and preventing damage to the eye. The doctor may prescribe these with or without corticosteroids, as discussed below.
Corticosteroids: these come in many forms, including oral, injections, IVs, and the likes. These are helpful where the inflammation is not as a result of an infection. They work in reducing the inflammation. The form of the corticosteroids will depend on the extent of the uveitis. Suppose the condition affects one eye, the doctor can inject steroids into the affected eye. If this does not work, steroid pills may be necessary.
You should note that the use of steroids is not always advisable. Your doctor should take you through the possible side effects before administering the drugs. The side effects are often severe. The doctor should thus work on using as few steroids as they can.
These can also be in the form of an implant, which works best for chronic cases. The doctor will put this in the affected eye, such that it continuously releases steroids into the uvea. That way, you can avoid the side effects related to the oral administration of steroids.
Non-steroid anti-inflammatory drugs: where the uveitis is chronic and requires treatment over a long time, these can work. They are effective in the long term. However, they are not common.
A new treatment known as corticotropin has come into the market in recent years. It works in reducing inflammation and has fewer side effects compared to steroids. It is under examination at this time.
Immunosuppressive Agents: in many cases, the cause of the uveitis is not clear. However, where the inflammation owes from a disease, you will need meds to work on the underlying condition.
Immunosuppressive agents work in weakening the body’s immune response. They can be effective for patients who have recurrent inflammations in both eyes and don’t respond to anti-inflammatory drugs. They also work for people at risk of suffering vision loss, where medical interventions are not in place. However, taking immunosuppressive agents leave patients at risk of infections.
Vision Loss caused by uveitis
People suffering from uveitis often experience a blur in their vision as well as reduced vision. After getting treatment, they can regain their vision without adverse effects. But in some cases, the inflammation can damage the retina and optic nerve, thus affecting vision. That is especially so where the inflammations are recurrent. Here are some ways through which uveitis can cause vision loss:
Added Eye Pressure: inflammation in the uvea can increase eye pressure, a condition known as ocular hypertension. This added pressure can be damaging to eye parts such as the optic nerve and the retina. About 20% of uveitis patients develop this added pressure.
Glaucoma: The use of steroids in the long term can lead to the development of glaucoma. When this happens, you should consult your doctor, who should put you on a strict treatment plan.
Cataracts: these appear as clouds on one’s eye lens. When cataracts do not owe to inflammation, the doctor can replace the lens with artificial ones. However, when inflammation is present, this replacement becomes tricky. The doctor must wait until the swelling goes down before performing surgery on the affected eye.
In some cases, inflammation could be as a result of cataract surgery. Thus, performing surgery when inflammation already exists would only aggravate the problem. Patients who use steroids in the long term are at high risk of developing cataracts.
Cystoid macular edema: this condition, abbreviated as CME, is a common complication of uveitis. It takes place when the macula swells. This part of the eye is necessary for detailed work, such as reading. It is essential to bring inflammation down to ensure that the macula functions as needed. Where treatment does not work, the cells in the macula can die, thus reducing vision. It could also cause vision loss.
Vitreous damage: the vitreous is the gel-like part of the eye. Light passes through this to reach the retina for the processing of images. When you are young, this part nourishes the eye. Over time, it works to provide the eye with shape. When this part suffers damage, floaters may appear in your vision, thus disrupting your view.
Floaters are shadows cast on your retina, owing to debris floating in the vitreous. In some cases, the floaters may be severe such that they block vision or come accompanied by flashes of light. Often, the doctor will start by administering drugs to address the cause of the floaters. If these do not work, the doctor can replace the vitreous with a similar liquid through surgical operations.
Retinal detachment: when you suffer posterior uveitis or panuveitis, the condition affects the back part of the uvea and the retina. This inflammation can lead to tears or holes in the retina. When these go untreated, they allow for leaking of fluids into retinal layers, thus causing the retina to shift in position. This shift exhibits through floaters, flashes of light, and decreased vision.
It is a medical emergency that calls for immediate surgery to rectify the change. You should be on the lookout for any warning signs of the same.
Living with Uveitis
We live in a modern age where numerous treatment options are available to people with uveitis. With these treatments, you can avoid suffering reduced vision or loss of vision owing to inflammation. The possibility of recovery depends on the affected eye part and the extent of the inflammation. It also comes down to the likelihood of recurring.
You should work with a licensed eye doctor when facing inflammation. They can work out a treatment plan to ensure that you get alleviation from your symptoms.
Glaucoma
If you have eye redness with pain, this could be an indication of glaucoma. Often, glaucoma does not exhibit any symptoms in the early stages, which makes it a dangerous disease. Also, where proper treatment is not in place, this condition could lead to blindness.
But there is good news. As long as you get regular exams done, your eye doctor could catch this condition in its early stages. That would allow for timely treatment that would save your sight.
For you to understand how glaucoma affects the eyes, you should understand the parts of the eye. In earlier parts, we covered the uvea and eyelids, as well as the retina and optic nerve. We will focus a lot on the optic nerve, which sends signals to the brain. The optic disc is also essential in this case as this is where the nerve fibers come together, creating the optic nerve.
Eye drainage is an essential part of the proper functioning of the eyes. The clear liquid at the front of your eyes is the aqueous humor. We had earlier mentioned that the ciliary body produces this fluid. This fluid flows out through the pupil into the eye’s drainage system.
All this affects the inner pressure of the eye, known as intraocular pressure, or IOP. The pressure depends on how much production of the fluid takes place and how much of it drains out of the eye. Now, if the eye is working as it should, the fluid should flow with ease, ensuring a balance in pressure. This flow is a continuous process.
How does glaucoma affect this balance? Well, you have tons of nerve fibers running from the retina, creating the optic nerve. All these converge at the optic disc. When you have glaucoma, your eye’s drainage system may not work, and this causes clogging. Without a free flow, this fluid builds up, and this creates pressure in the eye.
What happens next? With no release, the nerve fibers are susceptible to damage, and this can lead to loss of vision. This damage causes the optic disc to start hollowing as it takes on a cupped shape. With an eye exam, doctors can point out this change and possibly relate it to glaucoma.
Let’s continue to how this pressure affects your sight. The pressure should not be a problem if it lasts for a short while. Your eye’s drainage system can withstand a slight change in pressure now and then. However, it will not work well when the pressure remains high for long periods at a time. This added IOP can damage the optic disc, and this can lead to loss of vision.
You should note, though, that having a normal IOP does not mean that you cannot get glaucoma. There have been cases where people with generally regular IOPs suffered vision loss owing to glaucoma. Research on the same is ongoing.
Glaucoma often affects people in both eyes. However, pressure starts building up in one eye, causing small changes at first. Most people experience a loss in their side vision, which they do not notice in most cases. Over time, the vision loss moves on to the central vision, which people start noticing.
Unfortunately, sight lost owing to glaucoma cannot get restored. But if you catch the changes in eyesight from an early stage, you can prevent such a loss. That’s why eye exams are essential.
Are you at risk?
Earlier, we mentioned that even people with normal IOP could get glaucoma. That means that not only people with added pressure in their eyes are at risk. Can you get this disease? Well, the answer is yes. This disease affects anyone, regardless of age and gender.
However, some people are at more risk of getting it than others. Examples include people aged sixty going up, those on steroids, those with myopia and those with a family history of glaucoma. You are also more likely to get it if you are of Asian, African, or Hispanic descent. Medically, those with thin central corneas, eye injuries, and high pressure are at more risk.
Glaucoma symptoms
Catching this disease early allows you to avoid more severe consequences in the future. The most common form of glaucoma is the primary open-angle glaucoma. In this case, the buildup in pressure is very gradual. As such, it is hard for affected people to point out any symptoms.
Often, patients do not suffer pain or discomfort and start by losing their side vision. Most people do not notice this loss as we use the central vision for most tasks. Once the disease progresses to the final stages, central vision gets affected. At this point, people can notice a change in their side vision, which by this time is heavily affected.
In other forms of glaucoma, symptoms may be present, allowing patients to point out the same. They include redness, pain, blurred vision, and loss of sight, nausea, and the appearance of bright lights with rainbow color circles, among others. When you experience one or more of these symptoms, you should consult a licensed eye doctor.
The need for medical exams
The sooner you detect a change in your eyes, the sooner you can fix it. Getting regular eye exams works in enabling you to protect your eye health. Usually, eyesight changes start at the age of forty. At this point, you should have started your eye screenings to ensure nothing adverse happens.
The results of this will determine how often you should get check-ups. Where you have underlying health conditions, you should check with your doctor as to the frequency of your eye exams.
Types of Glaucoma
We have stated that primary open-angle glaucoma is one of the most common forms of glaucoma. The other is primary angle-closure glaucoma. While there are other forms of this disease, these two are the most common. Let’s look at how they exhibit:
Primary open-angle glaucoma: This form of glaucoma also goes by the name open-angle. It accounts for most of the glaucoma cases, averaging 90% of the reports. In this case, the angle where the iris meets the cornea is open, but eye drainage does not happen as it should. A buildup takes place, which creates pressure and damages the optic nerve.
Unfortunately, there are no warning signs for this condition, which develops over the years. Where no diagnosis takes place, patients can experience a loss in vision over time. But with regular eye exams, doctors can catch it in the early stages. The good news is that the condition responds well to treatment, thereby saving your vision.
Primary Angle-Closure Glaucoma: This condition also goes by the name narrow-angle glaucoma. In this case, the angle in most areas between the iris and cornea remains closed. As such, fluid drainage is not possible, and this results in added eye pressure. If this does not get rectified, damage to the optic nerve could occur, leading to a loss in vision. In the early stages of this disease, the angle may experience closure without a spike in eye pressure.
Pressure builds up over time. As is the case with open-angle, no symptoms are often present. It is quite rare for the rise in pressure to be fast. When this happens, it goes by the name acute angle-closure. In this case, you suffer symptoms such as eye redness with pain, blurred vision, nausea, and seeing halos around lights. When this happens, you need to seek immediate medical attention, as it is an emergency. If you delay treatment, you can lose vision permanently.
There are other forms of glaucoma, which borrow from the main two above. These variations can affect one or both eyes and can also result in loss of vision. They are as follows:
Normal-Tension: It also goes by the name low-tension. Here, the optic nerve suffers damage even though the eye pressure is not elevated. It is not clear what causes this damage, and research on the same is underway.
You are at more risk of getting this condition if people in your family have a history of the same. You can also get it if you have Japanese roots, migraines, low diastolic blood pressure, or heart disease.
Secondary Glaucoma: This condition comes about owing to another health condition that spikes the pressure in the eye. A good example would be where someone suffers inflammation such as uveitis, as earlier covered. This inflammation can lead to added pressure that could damage the optic nerve and cause a loss in vision.
Other causes include eye trauma and the use of drugs, among others. The course of treatment will depend on the form of glaucoma exhibited i.e., open-angle or angle-closure.
Uveitic Glaucoma: As covered under secondary glaucoma, other health conditions can lead to increased pressure in the eye. Uveitis can be one such factor. It takes place when the uvea becomes inflamed, which can disrupt the flow of the aqueous humor.
In some cases, glaucoma may result from taking steroids as a treatment for the inflammation. These meds can damage the drainage canals, thus causing a buildup in the eyes.
Traumatic Glaucoma: This condition is a variation of open-angle. It takes place when one suffers blunt or penetrative trauma to the eye. It can exhibit immediately after the injury or develop in the times that follow, and falls under secondary glaucoma.
Pigmentary Glaucoma: This condition comes about when pigment granules from the iris enter the aqueous humor and block the drainage canals. It is a form of open-angle that heightens the pressure in the eyes, thereby posing a risk to the optic nerve. This condition is more prevalent in young male Caucasians with myopia.
Congenital Glaucoma: This form of glaucoma presents in babies whose eyes had not fully or correctly developed at the time of birth. When this happens, the pressure in their eyes can damage their optic nerves, leading to vision loss.
This condition presents as large eyes, frequent tearing, light sensitivity, and cloudiness in the cornea. This rare condition can get passed from one generation to the other. This condition can be corrected through surgery.
Neovascular Glaucoma: This condition comes about when new blood vessels form on the iris as well as over the drainage canals in the eye. This abnormal growth blocks the drainage paths and causes an increase in pressure. Often, this growth owes to other health conditions such as diabetes.
Exfoliative Glaucoma: This condition also goes by the name Pseudoexfoliative Glaucoma. It takes place when materials which have a dandruff-like appearance break off from the lens in the eye. These break-offs collect between the iris and cornea and can clog the eye’s drainage system. The rise in pressure resulting from this can damage the optic nerve. This condition is a form of open-angle and is prevalent in certain racial groups.
Glaucoma diagnosis
Accurate diagnosis of glaucoma enables you to receive timely treatment and thus avoid vision loss over time. You should, therefore, get regular eye exams conducted by a licensed eye doctor. Without getting into detail, your doctor will assess five main factors during the eye exam.
The first is tonometry, which is a measure of the pressure inside your eyes. The doctor uses drops to numb the eye for this process.
The second is ophthalmoscopy, which assesses the shape and the color of the optic nerve. Often, this test also goes by the name dilated eye exam. It owes to the use of eye drops to widen the pupil for ease of examination.
The third is perimetry that checks your field of vision. With this, the doctor can assess if there are any changes in vision. This test involves the use of light placed in your peripheral vision.
Additionally, the doctor will use gonioscopy, which assesses the angle at which the iris meets the cornea. Eye drops will be necessary in this case, too, to numb the eyes.
Pachymetry, which measures the thickness of the cornea, is also essential. This thickness influences readings on eye pressure and has a bearing on suitable treatment plans for you.
You may wonder why you need to undergo so many tests. The thing is, diagnosing glaucoma is not an easy fete. Your doctor needs to fully understand what is happening in your eyes before coming up with a treatment plan. It is only in this way that they can protect your sight. You can always get a second opinion to ensure that you get the best treatment possible.
Glaucoma treatment
The main issue with glaucoma is heightened eye pressure. As such, treatment options will lean on lowering the IOP. Doctors can do this through meds, incisional surgery, laser treatments, or a combination of all these. The course of treatment will ultimately depend on the glaucoma type and patient needs. Below are the possible modes of treatment.
Open-Angle treatment
For patients with open-angle, treatment methods are as follows:
Selective laser trabeculoplasty: this treatment, abbreviated as SLT, works in reducing eye pressure. It takes five to ten minutes and may cause blurry vision for a while. Patients who are already using eye drops can also undergo this treatment. It involves the use of laser light to improve drainage in the eye.
The effects of this should last for two to three years, or longer, depending on the patient. The upside of this treatment is that it does not alter the drainage canals. Thus, repeat sessions are possible and practical. This treatment can work in itself for some patients. Others, however, will require other treatments such as meds and surgery.
Meds: medicines can work in reducing the fluid generated or helping in the eye’s draining abilities. The doctor will advise you on how often you need to take your meds to keep the pressure at a reasonable level. People with glaucoma can be on medication for years.
Over time, your need for meds may change. That is not an indication of the condition of glaucoma. Instead, it points to the body building a tolerance for the meds, thus reducing their effectiveness.
In most cases, the doctor will advise that you use eye drops. Earlier on, we covered how you can use eye drops. You can use these tips in this case.
Note that the use of drops can have side effects over time. Where you notice a change in mobility or vision, you should talk to your doctor. You should also ensure that the drops do not interact with other medicines you may be taking. Examples of side effects include reduced blood pressure, fatigue, burning in the eyes, small bleeds, and reduced pulse rate, among others.
Incisional Surgery: in some cases, meds and laser treatments may not work in reducing the eye pressure as needed. In this case, incisional surgery may be the way out. It takes some time to recover from the incision. Your doctor will advise you on what you should do during recovery time.
Trabeculectomy is one such procedure where the surgeon makes a cut in the white part of the eye. This opening allows the aqueous humor to flow out instead of using the clogged drainage canals. You will need special meds to prevent the closure of this new opening. You get stitches in the cut part and take a few weeks to recover.
The other procedure is the aqueous shunt where the surgeon implants a tube into the eye. The tube works in draining the fluid out of the eye. The recovery period takes weeks.
Angle-Closure treatment
In this case, treatment options are as follows:
The doctor can use laser peripheral iridotomy to make an opening on the outer part of the iris. In some cases, the doctor may decide to treat both eyes even if only one shows signs of glaucoma. It acts as a precaution. Other than this, the doctor can use meds, trabeculectomy, and aqueous shunt options.
It is quite rare for the doctor to opt for SLT. Cataract surgery is another way to deal with high pressure. Removal of cataracts opens the angles and thus paves the way for reduced eye pressure.
The other types of glaucoma follow more or less the treatment options provided above.
Dry Eye
So far, we have covered three conditions, which can cause eye redness with pain. The list continues as we now cover dry eye, which is another possible cause. Dry eye comes about when there is a problem with your tears. It exhibits as redness, itchiness, sensitivity, and discomfort in the eyes, as well as other such symptoms.
While the name may have you thinking that the eye becomes dry, that is not always the case. Some people experience wateriness in their eyes as a result of dry eye.
The good thing with this condition is that it does not threaten your vision much, in most cases. Instead, it results in a blur in vision over short periods. The blurriness clears on its own or reduces when you blink.
This condition can affect one or both eyes and results in varying symptoms. Some affected people feel like they have something stuck in their eye, such as an eyelash. Try as they might, they cannot find anything in their eyes and are unable to shake that gritty feeling. That can be quite uncomfortable.
For others, the condition presents itself as watery eyes where the eyes tear more than is typical.
In most cases, dry eye does not affect vision in the long term. However, that does not mean that you should brush off its symptoms. Eyes are sensitive organs. As such, a change could indicate that you have an underlying condition you need to address. Anytime you come across a change in eyesight, you should consult a licensed eye doctor. They can recommend eye drops where you have a gritty feeling, which is often the case.
The unfortunate thing with dry eye is that it tends to be recurrent. Having this condition leaves you vulnerable to other such instances in the future. However, the discomfort will not always be the same.
In other cases, the dry eye is severe and presents as dryness and pain that could damage the front part of your eye. The extent of the dryness and its effects depend on the causative factor behind the same. That’s why you should seek medical attention to get to the root of the problem.
Dry eye risk factors
Many factors can lead to the development of dry eye, owing to a problem with your tears. It could be that you do not produce the quantity of tears needed for your eyes. Or you produce enough only that they are not of sufficient quality. Sometimes, it comes down to the distribution of the tears across the front part of the eye. Where distribution is inadequate, dry eye can occur.
This condition tends to affect older adults more. As you age, spreading tears through the eye surface becomes harder. It owes to a decrease in eyelid functionality. Also, tear glands become less effective, as does the tear film. These factors compounded pave the way for dry eye. Let us look at how all these factors come together:
The tear film: each time you blink, you hydrate the surface of the eye. Did you know that you blink ten to twenty times on average for each minute? This frequency can be less when you focus on something. As you shut and open your eye, you spread tears over the surface of the eye, creating a tear film. This film hydrates the eye and enables you to enjoy clear vision.
While it may seem like a small element, it plays a significant role in your eye health. It comprises three parts: mucous, water, and oil. The combination of these protects your eyes.
The mucous comes from the mucin layer, which is closest to the eye. It provides shape and positioning for the watery layer, which produces the water. The watery or aqueous layer hydrates the eye and provides nutrients to the cornea.
Also, it washes away debris from the eye surface and keeps it smooth. The lipid layer is furthest from the eye surface, and it works in sealing in the moisture. It also ensures that tears do not evaporate fast on exposure to the environment. Additionally, it works in ensuring the even distribution of tears over the eye surface.
The tear film is susceptible to changes in these three layers. For example, if there is less water in the aqueous layer, this will affect the makeup of the film. And this could result in the development of dry eye.
Dry eye causes
Now that we have established the importance of the tear film, we can take a look at possible causes of dry eye. This condition can affect you at any age, and it does not discriminate based on gender. However, it tends to affect women in their middle ages going up.
Changes in hormonal levels are to blame in some cases, such as dry eye during pregnancy. Let us see what else can affect the tear film:
Blepharitis and meibomian gland dysfunction (MGD)
These two conditions often result in dry eye. The first owes to inflammation of eyelids, which can be as a result of an infection. It can affect the lashes and the front of the lid margin (anterior blepharitis), or the back of the lid margin (posterior blepharitis). In the case of the latter, MGD could be to blame.
MGD is a health condition that owes to the blocking of the glands in your upper and lower lids. When these glands block, secretion of oil reduces, thus allowing for water to evaporate from the tear film. The result is dry eyes and discomfort.
People with either of these conditions should work on their hygiene standards. That way, they can alleviate the symptoms resulting from the blockage. Often, it takes days leading into weeks for you to see a change in the dry eye. Let’s look at how hygiene can work in your favor:
For anterior blepharitis
Blockage and inflammation will result in the formation of crusts on your lashes. You are likely to have a bacterial infection, and you should thus avoid touching your eyes much. You cannot avoid touching them altogether, as you will need to clean them.
Washing your hands with soap and water before and after touching your eyes is essential, as we covered under conjunctivitis. Cleaning works better when you have a solution of sodium bicarbonate and water. For each glass of water, you should add a teaspoon of the bicarbonate. Use this solution to clean your eyes using a clean tissue or cotton bud.
Clean the eyes from the nose heading to the outer part of your face. Do not re-dip the tissue or cotton bud. Instead, reach out for a clean one, wring out the excess water and repeat the process. Your doctor may recommend that you use a given cleaning solution or offer you wipes. Where this is not the case, you can use this solution and wipes.
For posterior blepharitis or MGD
In this case, you can use a warm compress. The heat works in unblocking the glands and releasing any trapped oil, thus alleviating the inflammation. Start by warming water and dipping a clean cloth in it. Wring out the excess water and place the cloth on the affected eye for at least five minutes. When the cloth feels cold to the touch, dip another into the water, and repeat this process.
As the warmth seeps into the glands, you should massage the skin towards your lashes. That means that you push the lashes towards the direction of the eyes. It eases the unblocking of the glands. It helps to practice hygiene as you would when dealing with anterior blepharitis.
Your doctor can present you with possible alternatives for the warm compress. You should not attempt to deal with any inflammation before consulting your doctor on the same.
Drugs
The dry eyes could be as a result of drugs you are using. You should consult your doctor as to the side effects of any medications you have used or are using. Examples of possible culprits include pain meds, antihistamines, and oral contraceptives.
Contact Lenses
People who wear contact lenses are also at risk of developing dry eye owing to a change in their tear film. You should consult your doctor as to the likelihood of the same. Also, it helps to follow the advice given by your doctor when handling the lenses.
Injury or Surgery
When you suffer trauma to the eye or undergo surgery, changes occur in the tear film. The effects of this can lead to dry eye, which lasts until the eye heals.
Possible Health Conditions
Some health conditions may contribute to a change in the tear film, more so when they are inflammatory. Your doctor will look into possible underlying conditions that could affect your eyes.
Dry eye symptoms
Dry eye can exhibit in many forms. They include eye redness with pain, discharge from the eye, gritty feelings, stinging and burning sensations, and excess tearing. Other symptoms include fatigue, blurred vision, and decreased visual attention, and reduced production of tears. Some people also suffer heavy eyelids.
Dry eye diagnosis
The only sure way to tell you have dry eye is through diagnosis by a licensed eye doctor. As such, if you experience any discomfort and irritation in your eyes, you should consult a doctor. The doctor will walk you through possible causes of the dry eye, including meds and environmental factors.
For example, if you work in a dusty place, you are likely to suffer dry eye. Other than a review of possible factors, the doctor will also take you through several tests. These tests not only confirm or rule out dry eye, but they also enable the doctor to come up with a treatment plan. The tests are as follows:
Tear film breakup time: in this test, the doctor finds out how long it takes for the eye surface to dry after blinking. The period taken can point to the possibility or lack thereof of dry eye. The doctor uses eye drops with a special dye that enables them to assess your tears with ease.
After administration of the eye drops, the doctor will ask you to blink severally. You then need to keep your eyes open without blinking to allow the doctor to assess the distribution of the dye.
Using light, the doctor can view the dye as they monitor the time taken for dry patches to form on the eye surface. If the patches appear within ten seconds, you could have dry eye. The dye used does not stain the eyes but could stain your skin if your tears touch your face. It is not permanent, though.
Schirmer Test: this test is not common, but it may be necessary where the dry eye seems severe. The doctor places a filter paper between the lower eyelid and the eye for about five minutes. After taking it out, the doctor can assess how many tears your eye produces within that time. Other than a filter paper, the doctor can also use a thread.
Dry eye treatment
The course of treatment will vary based on the extent and the cause of the dry eye. No specific treatment can cure the condition. Instead, the various treatment options work in alleviating the symptoms. As such, you end up feeling comfortable. The healing of the eye takes time and requires that you address the causative factor.
For example, if the dryness owes to meds you are using, you can switch other drugs. Where contact lenses are to blame, a break from the same could help.
In some cases, dry eye results from aging, which you cannot avoid. Here, the solution lies in alleviating the symptoms. You can use your natural tears, embrace eye drops, or reduce evaporation of tears. Your doctor will advise you on the best way forward. These methods work as follows:
Using natural tears: in this case, you need to be wary of your surroundings and make them more conducive to natural tears. For example, the use of central heating can lead to fast evaporation of tears. It would thus help if you minimized or avoided its use. If you must use heating, then incorporating a humidifier would aid in balancing the moisture in the room. That way, you do not suffer fast evaporation of tears, and you can keep dry eye at bay.
Daily tasks can also affect the state of the tear film. For example, you blink less when working on a computer, owing to the prolonged focus. It would help if you blinked more to hydrate the eye surface. An alternative would be the use of eye drops before engaging in tasks that call for a lot of focus. That way, the eyes would not dry out, and you would remain comfortable.
If the dry eye owes to MGD, the use of a warm compress can aid in alleviating the symptoms. It helps unclog the glands and thus promotes the health of the tear film.
Some studies have pointed to diet changes playing a role in alleviating dry eye. While these studies are inconclusive, it would not hurt to change your diet.
Using Eye Drops: Having dry eyes can be quite uncomfortable. Given that this condition owes to reduced hydration in the eye, you can use eye drops to alleviate the symptoms. Eye drops used in this case also go by the name artificial tears. They not only supplement, but they also replace natural tears to aid in hydration. They also prevent damage to the front part of the eye, which is likely when eyes remain dry for long.
Your doctor will prescribe the most suitable eye drops in your case. They will also advise you on how frequently you should use the drops. Where you find that the recommended dosage is not adequate, you should consult your doctor.
Do not attempt to increase the number of drops without a go-ahead from your doctor. Doing so could worsen the situation by aggravating the dryness. Your doctor will likely recommend another treatment for your case.
Artificial eye drops are one form of treatment your doctor can prescribe. Some of these have preservatives that could make your eyes sore. Your doctor should consider possible side effects when prescribing these to you.
Gels are more long-lasting as compared to eye drops, and you do not have to touch up on them often. The doctor may also suggest the use of ointment, which can moisten your eyes as you sleep. Some people sleep with their eyes partially open, which can aid in the evaporation of tears.
The ointment will ensure that the eye surface does not dry during the night. Given the sticky nature of ointments, they are best for the night as they can blur vision in the day.
Preventing Tear loss: You can prevent the occurrence of dry eye by blocking the drainage of tears. That is possible by blocking drainage holes in the eyelids. That way, tears remain on the eye surface for more extended periods.
The doctor can do this by using some plugs on the holes, which is often temporary. If this offers positive results, the doctor can leave the plugs in place. Alternatively, a small surgical procedure can take place to make the results more permanent.
The blocking of drainage holes does not mean that the use of eye drops will come to an end. In some cases, you may still need the drops, only that you will use them less often than before.
Corneal Abrasion
Eye redness with pain can also indicate corneal abrasion. The cornea is the clear front window part of your eye. It covers both the iris and the pupil. Under normal circumstances, this part should be clear and transparent. When you suffer a scratch to the eye, it impacts this window with numerous nerve endings. In some cases, the abrasion may lead to swelling and blurred vision.
Corneal Abrasion causes
You can get abrasion when something scratches or rubs on the front part of your eye. In most cases, abrasion comes about owing to eye trauma. Some people may also suffer impact owing to substances penetrating their eyes. You may think that only big impacts can affect the cornea, but that is not the case.
Eyes are very sensitive to impacts. Thus, even a dirt particle may graze the cornea and cause an abrasion. The same goes for soaps and other chemicals that come into contact with your eyes.
Corneal Abrasion symptoms
Symptoms vary per patient. Common signs of abrasion include pain and tearing in the affected eye, as well as light sensitivity. You may also feel that there is something lodged in the eye, yet you cannot see it. Eye redness, headache, and blurry vision may also indicate an abrasion. With children, there is increased fussiness.
Diagnosis and Treatment
If you notice any of the symptoms above, you should consult an eye doctor. The symptoms do not necessarily point to abrasion in your cornea. The doctor will assess your eye by adding some numbing drops as well as a yellow dye in it. The yellow dye will stain the eye. When the doctor uses a blue light on the eye surface, they can tell if there is an abrasion.
While corneal abrasion is uncomfortable, it is often not serious. For that reason, you can expect that the redness and pain will clear in the next day or two. The doctor will prescribe some pills for the pain, alongside some eye drops or ointment. The extent of the meds will depend on how severe the abrasion is.
In some cases, all you need is some rest, and the problem will clear over time. For children, wearing an eye patch may be necessary to prevent any aggravation of the problem.
Corneal Abrasion prevention
Corneal abrasions are common, more so in children. It is thus best that you learn how to protect yourself and your loved ones. If you look at most household cleaning items, manufacturers state that you should keep such liquids away from your eyes. They also advise that in case you get a substance into your eyes, you should wash it out. This advice works great in the prevention of corneal abrasions.
Ensure that you wash out any chemicals that spill into your eyes with running water for at least ten minutes. Follow through with seeking medical attention to ensure the chemical has not hurt the eye.
If a foreign material gets into the eye, you should try blinking or pulling on the upper eyelid over the lower one. That works in removing the material without harming the eye. More often than not, people use their fingers to get rid of the material. Your fingers and nails could result in more abrasion in the process.
It helps to avoid aggravating the eye. As such, if something gets into your eye, do not rub it. That may be your first instinct, and it will work against you. Instead of making the situation worse, use a clean cloth or soft tissue if the material is on the white of the eye.
If the material is on the cornea, leave it be. Trying to remove it will cause more harm than good. Try blinking to move it to the white of the eye. If this does not work, you should seek medical attention.
You should always use protective eyewear where your eyes are likely to come into contact with foreign substances. An example would be where you are mixing chemicals in the lab. Not wearing adequate protective gear puts you in the frontline for abrasion. Also, when engaging in contact sports, ensure that you use the required protective wear.
With children, you have to be extra careful. Teach them the importance of protecting their eyes. Also, ensure that you keep them away from dangerous items such as fireworks and lab chemicals.
Corneal Ulcer
Hearing about a corneal ulcer may have you thinking that this is a severe condition. The truth is that it is. A corneal ulcer is as painful as it sounds. It is an open sore that occurs on the cornea. If not managed as needed, it can lead to a loss of vision and could pave the way for blindness. The cornea is ordinarily transparent when no adverse changes have taken place.
When you have a corneal ulcer, it exhibits as a greyish white cloud on the cornea. Sometimes, you may not see the extent of the ulcer, given its small form. As such, some people may have trouble figuring out why they are in pain. However, under sufficient lighting, it should be easy to point out the ulcer. Let’s look into this more.
We will start with the cornea. When you look into the mirror, what you see is the front part of the eye. From this angle, you can see the iris, cornea, pupil, sclera, and conjunctiva. The cornea is the transparent layer that protects the iris and the pupil. It does not comprise blood vessels and relies on tiny vessels along its edge to supply it with elements.
While the cornea might seem small, it encompasses five layers. The first is the epithelium, which absorbs nutrients and oxygen from tears. The bowman’s layer is next, and this works in forming scar tissue in the event of an impact. The cornea depends on the stroma for strength, elasticity, and shape.
From here, we have the Descemet’s membrane, which protects the iris and pupil from infections and injuries. Finally, there is the endothelium, which ensures that there is no fluid buildup in the stroma. Also, it keeps it transparent.
As a whole, the cornea works in protecting the eye from harmful materials such as dust and germs. However, it does not undertake this task on its own. The eye also relies on other parts such as the sclera. Primarily, the cornea controls the light entering the eye and focuses it. The lens aid in focusing light, but the cornea accounts for 65-75% of this function.
Corneal ulcer causes
Up to this point, you can see that the cornea is essential in the healthy functioning of the eye. What can cause an ulcer in this essential part? Well, there are many types and causes of this condition as follows:
Infectious ulcers
These are the most common types of corneal ulcers, and they result from disease-causing microorganisms. A form of this would be bacterial infections caused by bacteria in the eyes. People who often wear contact lenses are at risk of these kinds of ulcers.
Another form would be viral infections, which result from viruses. People with herpes simplex and other such viral diseases are at risk of this. Often, the ulcers come about owing to triggers in the immune system. Common causative factors, in this case, include stress and exposure to sunlight.
Fungal infections are another type of corneal ulcers. These result from fungi in the body. It could be that one is not wearing their contact lens as they should. In other cases, the use of steroid eye drops and injuries to the eyes could be to blame.
Parasitic infections are also likely causes of corneal ulcers. An example, in this case, would be amoeba, which is prevalent in freshwater and soil. If this gets into the eye, it can cause keratitis, which is a severe condition.
When tears get into the cornea, they could also result in the formation of corneal ulcers. Tears can penetrate the layers owing to trauma to the eyes.
Non-Infectious causes
In this case, the corneal ulcers result from underlying health conditions as follows:
Dry Eyes: we had earlier covered the causes and symptoms of this disease under possible causes of eye redness with pain. Not only can dry eye cause infections, but the dryness can result in corneal abrasion. All these can lead to the development of corneal ulcers.
Bell’s Palsy: this condition comes about owing to muscle weakness or paralysis of the facial nerve. It affects the movement of eyelids as well as other facial organs. Where the eyes undergo strain due to this condition, dry eye syndrome can occur in severity. And this can lead to the development of ulcers.
Other health conditions, such as keratitis and autoimmune diseases, can also be to blame. For this reason, your doctor will start by ruling out the possibility of underlying health conditions during your assessment.
Corneal ulcer symptoms
If the ulcer results from an eye infection, you can stop its formation by timely dealing with the infection. Signs of an infection include redness with pain, wateriness, eye discharge, burning, and stinging sensations, as well as light sensitivity.
Where the infection does not get dealt with, it can lead to the occurrence of eye ulcers. These symptoms exhibit as eye redness with severe pain, tearing, eye discharge, swelling of the eyelids, light sensitivity, white spots, and blurred vision.
Where any of these symptoms occur, you should consult an eye doctor. Failure to do so can lead to the development of a much severe condition.
Possible Complications
Where you do not treat corneal ulcers as needed, you can pave the way for more severe conditions. They include vision loss, scarring of the cornea, and spread of infections, ulcer perforation and loss of the affected eye. These are but some of the most likely complications resulting from a lack of timely medical interventions.
Corneal ulcer diagnosis
Having any of these symptoms does not mean that you have a corneal ulcer. It could also be an indication of other health complications. The doctor will thus assess the state of the eye to figure out if you have a corneal ulcer.
The testing will involve the use of a fluorescein eye stain. With this in the eyes, the doctor will have an easy time looking for any changes in the cornea. Where there is a likelihood of an eye infection, the doctor may opt to take samples of the eye tissue. For this, the doctor will administer local anesthesia to numb the eye before collecting the tissue. From this, the doctor can tell what infection is behind the ulceration.
Corneal ulcer treatment
The course of treatment will depend on the cause of the ulcer.
For infections, the doctor will need to treat the underlying conditions by administering drugs for the same. These include antibiotic, antifungal, and antiviral eye drops, depending on the microorganism in question.
In some cases, tablets may be necessary to manage the infection. Where swelling or inflammation occurs, the doctor can use anti-inflammatory eye drops. They can also use corticosteroids, as long as this happens under their close watch. Given that severe pain is a symptom of this disease, the use of pain meds will be necessary.
Conjunctival flap surgery is also an option. However, its adverse side effects may make it unsuitable for your case. For some patients, this surgery can lead to vision loss. That’s why it is best for people who already have vision loss. It works in reducing the pain experienced as a result of the ulcer.
Patients who need comfort can use this treatment. While this surgery has adverse effects, it may be the best choice for people with infections that do not subside after medication.
Corneal transplants can work in the treatment of these ulcers. Doctors use these when the ulcer does not respond to other treatments. They can also use this when the ulcer causes perforation in the cornea. Where a transplant is successful, the patient can regain vision.
Most operations are successful, as there is a low rejection rate in this case. Where adverse effects follow the transplant, the doctor will advise you on the way forward, as they monitor the situation.
Episcleritis
Your eye redness with pain could indicate inflammation in your sclera. The sclera is an elastic and opaque tissue in the eye. It makes up for up to 90% of the outer coat. It starts at the limbus and ends at the optic nerve canal.
You see it as white, though in children, it has a bluish color. That’s because children have a thin sclera that allows you to see the form of the choroid. As you grow older, fat deposits in this layer make it yellow. The thickness of this layer varies based on its position. Towards the optic nerve, it is up to one mm thick, and towards the extraocular muscles, it measures 0.3 mm.
The episclera, on the other hand, comprises connected tissues covering the sclera. It consists of vessels, nerve fibers, and collagen bundles. Where you have an inflammation of the sclera, you will have a complication in the episclera too. However, you can have episclera complications devoid of problems in the sclera.
Episcleritis can affect anyone, though it has a higher prevalence in young to middle-aged females. People suffering from this condition often encounter eye redness, which may or may not have irritation. This redness exhibits for one to three days before clearing. Some patients experience more redness and pain than others, depending on the extent of the inflammation. Also, some people are more at risk of having recurrent episcleritis.
Half of the known cases do not have an apparent cause. In other cases, underlying health conditions such as rheumatoid arthritis can be to blame. Having this disease is often not a cause of concern as it usually clears in entirety. Also, it does not have any adverse effects on the eye when managed as needed. Some patients, however, get episcleritis as a complication of other diseases such as glaucoma and uveitis, as covered earlier.
Episcleritis symptoms
Patients experience eye redness with irritation. The eye could be tender to the touch. The inflamed vessels appear bright red, and moving the vessels using a cotton bud is relatively easy. Watering of the eye and sensitivity to light could also present.
Episcleritis diagnosis
Having these symptoms could indicate the presence of episcleritis, scleritis, or another eye disease. It is thus best that you seek medical attention to figure out the way forward. The doctor will assess your medical history before examining the affected eye with a slit lamp.
They will check for inflamed vessels as well as the ability to move the same. They also use blanching with topical phenylephrine. If the vessels blanch, there is a high likelihood that your episclera is inflamed. Not all episcleritis cases are the same. It can either be diffuse or nodular. The first is the simple case, which can affect one or all of the episclera. The second is nodular, which affects one elevated area.
Episcleritis treatment
In most cases, episcleritis clears within three weeks, with or without treatment. Your doctor will monitor the situation to ascertain what works best in your case. Where the condition is recurrent, there will be a need for meds such as topical NSAIDs to bring down the inflammation.
Note that the continued use of such drugs can have adverse effects on the body. We had earlier covered a bit of the same under Uveitis and Glaucoma.
The clearing of the inflammation will depend on the kind of episcleritis you have. Nodular cases take longer to clear and will call for systemic meds.
Scleritis
This condition points to severe inflammation of the sclera and often characterizes as eye redness with pain. Where you do not receive timely treatment for this disease, you could suffer a loss in vision. As is the case with episcleritis, this condition is more present in women than men. Also, it affects people in their middle ages going up, more than others.
Scleritis causes
Many factors could lead to the inflammation of the sclera as follows:
- Idiopathic: here, the inflammation results from a disturbance in the scleral specific antigens. These are autoimmune reactions whose causes are unknown.
- Systemic diseases: half of the people with scleritis have a form of underlying systemic disease. One such example is rheumatoid arthritis, which accounts for 10-33% of the reported scleritis cases.
- Infections: the spread of disease-causing microorganisms could be to blame for the inflammation. These microorganisms invade parts of the sclera and cause inflammation.
- Surgery-induced cases: while this is rare, it can be the causative factor behind inflammation of the sclera. It occurs when a patient has undergone surgery and has a poor prognosis. It is thus essential that your doctor takes this into account to ensure you get an early diagnosis. Lack of adequate management could lead to the perforation of the sclera.
Scleritis symptoms
This inflammation causes severe pain that wakes patients from their sleep. Eyes feel tender, moderately, or severely, and they exhibit purple-red vessels. You cannot move these vessels with a bud with ease. Also, the blanching of the vessels does not take place when you use phenylephrine.
Scleritis diagnosis
The doctor will assess your medical records while undertaking several eye examinations. If the posterior sclera is involved, there may be a need for imaging. Eye redness with pain is common in patients with anterior scleritis. The symptoms start slowly and worsen over the days that follow. The pain gets worse upon the movement of the eyes and can wake you from sleep. It moves from one part of the face to the other such as from the scalp to the jaw.
This disease requires timely diagnosis and treatment, or else, it can pave the way for other complications. These include glaucoma, uveitis, cataracts, corneal thinning, and scleral perforations, among others.
Scleritis treatment
This condition requires treatment in the long term and often calls for oral steroids and immunosuppressive drug therapy. Your doctor will decide on what is best in your case.
Conclusion
Having eye redness with pain could be an indication of a mild disease such as conjunctivitis. It could also indicate the onset of a much bigger problem, such as glaucoma. You should thus be on the lookout for any changes in your eyes, ensuring that you report the same to a licensed eye doctor.
That way, you can avoid severe complications such as the loss of vision or ocular pain over extended periods.
