Persistent Red Eyes: Causes, Treatments, and Solutions Explained

Q: Persistent Red Eyes: Causes, Treatments, and Solutions Explained

Hello： Red eyes can be a symptom caused by various conditions, such as iritis, conjunctivitis, and keratitis. <br>However, you did not mention experiencing any discomfort associated with the redness, making it difficult to determine the underlying cause. <br>Vasoconstrictors can

The eyes are very red?

Hello Dr.
Feng,
I have been experiencing persistent redness in my eyes for about five years, which is quite severe.
My eyes are red all day, regardless of the time.
I have visited dozens of hospitals and clinics, and the diagnoses have all been either keratitis or conjunctivitis, or attributed to air pollution.
Some doctors have even told me that this condition will never improve.
I have been using eye drops for a long time, but there has been no improvement.
Initially, I used vasoconstrictor eye drops, which reduced the redness, but over time, the blood vessels no longer constrict, and my eyes remain red even after using the drops.
It feels like the microvessels have enlarged, making the redness more pronounced.
People say that wearing contact lenses can cause eye redness, but I do not wear glasses or contacts since I am not nearsighted.
My eyes do not have any other symptoms and do not hurt, and my vision remains good.
However, sometimes my eyes feel very fatigued, but there are no other issues.
I would like to ask Dr.
Feng if there are any treatment options or surgeries that can help reduce the redness in my eyes.
One doctor mentioned using electrocautery, but I am not familiar with that method.
I would appreciate your guidance on what can be done to completely resolve the redness without any side effects.
Thank you, Dr.
Feng.

Wo bu shi xiao bai tu, 20~29 year old female. Ask Date: 2006/03/20

Dr. Feng Jiefan reply Ophthalmology

Hello: Red eyes can be a symptom caused by various conditions, such as iritis, conjunctivitis, and keratitis.
However, you did not mention experiencing any discomfort associated with the redness, making it difficult to determine the underlying cause.
Vasoconstrictors can temporarily alleviate red eyes, but long-term use may lead to ineffectiveness and increased redness, similar to your current situation.
Electrocautery is typically used for specific vascular conditions, such as varicose veins.
It is advisable to identify the underlying cause and seek assistance from a cornea specialist to address the issue fundamentally.
Sincerely, Dr.
Feng Jie-Fan, Ophthalmology.

Reply Date: 2006/03/20

More Info

Persistent red eyes can be a frustrating and distressing condition, especially when it has lasted for an extended period, as in your case of five years. The symptoms you describe, including the presence of blood vessels and the lack of pain or visual impairment, suggest that you may be dealing with a chronic form of conjunctivitis or another underlying issue that has not been adequately addressed.

Possible Causes of Persistent Red Eyes
1. Chronic Conjunctivitis: This is an inflammation of the conjunctiva, the membrane covering the white part of the eye and the inner eyelids. Chronic conjunctivitis can be caused by allergens, irritants, or infections. If the underlying cause is not identified and treated, symptoms can persist.

2. Allergic Reactions: Allergies to pollen, dust, pet dander, or other environmental factors can lead to chronic redness and irritation. If you have not been tested for allergies, this might be a worthwhile step.

3. Environmental Factors: Prolonged exposure to pollutants, smoke, or dry air can exacerbate eye redness. If you live in an area with high pollution levels, this could be contributing to your symptoms.

4. Vascular Changes: Overuse of vasoconstrictor eye drops (which reduce redness) can lead to a rebound effect, where the blood vessels become more prominent when the drops are not used. This could explain why your eyes appear redder after using these drops for an extended period.

5. Dry Eye Syndrome: Chronic dryness can lead to irritation and redness. Symptoms can be exacerbated by environmental factors, prolonged screen time, or certain medications.

Treatment Options
1. Identify and Treat Underlying Causes: A thorough examination by an ophthalmologist is essential. They may perform tests to determine if allergies or other conditions are contributing to your symptoms.

2. Switching Eye Drops: If you have been using vasoconstrictor drops, it may be beneficial to stop using them altogether. Instead, consider preservative-free artificial tears to help lubricate your eyes without causing rebound redness.

3. Allergy Management: If allergies are identified, antihistamine eye drops or oral medications may help alleviate symptoms. Avoiding known allergens is also crucial.

4. Environmental Modifications: Using a humidifier, avoiding smoke, and reducing exposure to pollutants can help improve symptoms. If you are in a dry or polluted environment, wearing sunglasses outdoors can also protect your eyes.

5. Advanced Treatments: In some cases, procedures like punctal plugs (which block tear drainage to keep the eyes moist) or even laser treatments may be considered. The "electrocautery" method you mentioned is a procedure that can be used to cauterize blood vessels on the surface of the eye, which may reduce redness. However, this should be discussed thoroughly with a qualified ophthalmologist to understand the risks and benefits.

6. Regular Follow-ups: Continuous monitoring and follow-up with your eye care provider are essential. If your symptoms persist despite treatment, further investigation may be necessary.

Conclusion
Persistent red eyes can stem from various causes, and while it may feel discouraging, there are multiple avenues for treatment. It is crucial to work closely with an eye care professional who can tailor a treatment plan specific to your needs. Avoiding self-medication with over-the-counter drops that may worsen the condition is advisable. Instead, focus on finding a comprehensive solution that addresses the root cause of your symptoms.

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