Eye Redness

WHEN TO SEE YOUR DOCTOR

* The redness persists for more than two days.

* The redness persists for more than two hours after removing contact lenses.

* You also have yellow or thick eye discharge.

* You also have piercing, throbbing pain, blurred vision or sensitivity to light.

What Your Symptom Is Telling You

Forget Bette Davis eyes! You've got Rand McNally eyes: orbs lined like road maps (and you haven't even left town). Perhaps you were swimming in a chlorinated pool, had one beer too many at the barbecue or rubbed your eyes a bit too vigorously. Any one of these factors can dilate the tiny blood vessels within the whites of your eyes, making them red.

Pinkeye, for example (the common name for red eyes accompanied by a yellowish, crusty discharge), is a highly contagious infection that can circulate in classrooms faster than crib notes. Red eyes with a clear, watery discharge and a sore throat often indicate the onset of a cold.

But redness comes in all shapes and sizes—for instance, a little red blob that appears suddenly on the white of one eye. It may look frightening, but it's usually harmless, according to Mitchell H. Friedlaender, M.D., director of corneal services in the Division of Ophthalmology at the Scripps Clinic and Research Foundation in La Jolla, California, and coauthor of 20/20: A Total Guide to Improving Your Vision and Preventing Eye Disease. These red blobs are blood vessels that burst during a bout of sudden pressure, like a powerful sneeze or while straining to lift the sofa. They're common among older people and usually fade in a week or so.

The most serious cause of red eyes is keratitis, an inflammation of the cornea that's usually caused by a contaminated contact lens.

Symptom Relief

The rule is, if your eyes are red, don't rub," says Jason Slakter, M.D. attending surgeon in the Department of Ophthalmology at the Manhattan Eye, Ear and Throat Hospital. If the problem is an allergen like pollen, rubbing could trigger the release of more histamine—the allergen-sparked chemical that caused your eyes to redden in the first place. And remember, no matter what the cause, your eyes are red because they're irritated. Rubbing only irritates them more.

Here's what to do instead.

Play it cool. A cool compress can provide relief for redness from a cold virus or allergen, says Dr. Slakter. Soak a clean washcloth in cold water and relax for ten minutes with the cloth over your closed eyes.

Fumigate your shopping list. To help relieve red, weepy, itchy eyes, try using only unscented tissues, cosmetics, soaps and laundry detergents. You may have an allergy to the perfumes in these items.

Fake it. Over-the-counter artificial tears can soothe red eyes caused by dry air or smoke-filled rooms.

"Decongest" your eyes. For bloodshot eyes from pollution or pollen, look for "eye decongestant" drops that constrict blood vessels (vasoconstrictors) and remove the red. (Some brands include an antihistamine that counteracts allergic itchiness and swelling.) But using vasoconstrictors longer than three days could give you "rebound redness," because the blood vessels react to the drug by overdilating. "You may wind up with redder eyes than ever," says Dr. Friedlaender. If your eyes are still bloodshot after a day or two of using decongestants or you have excessive discharge, see the doctor.

Take your antibiotic faithfully. If you have pinkeye, you need to use antibiotic eyedrops for a week to ten days to kill the bacteria, according to Kenneth Kauvar, M.D., assistant clinical professor of ophthalmology at the University of Colorado School of Medicine in Denver and author of Eyes Only. To insert the drops, pull the lower lid down gently, look up and place a drop in the space between the lower lid and the eyeball. Close the lid for a few seconds.

Don't spread it around. If you have pinkeye, wash your hands frequently. "You could easily spread the infection to the other eye or to another person," says Dr. Kauvar. Also, change your towels, washcloths and pillowcases every few days. And buy fresh eye makeup.

Take out your lenses. "A contact lens left in a red eye provides the perfect incubator for bacteria," says Dr. Slakter. If redness remains after removing your contacts, see your doctor.

Practice good lens hygiene. To avoid keratitis, you should clean and disinfect your lenses every time you remove them, using fresh solutions, says Scott MacRae, M.D., associate professor of ophthalmology at the Oregon Health Sciences University School of Medicine in Portland. Use only the commercial contact lens preparations recommended for your hard or soft lenses. Clean the lens cases, too. And never use homemade solutions or saliva on lenses.

Air your eyeballs overnight. Contacts worn continuously (even the extended-wear type) rub away the cornea, causing rips that invite infection, says Dr. Friedlaender. Contacts are also a barrier to oxygen and encourage bacterial growth. "Removing lenses overnight reduces the time a foreign body is on your eyes and cuts your chance of infection," he says.

Spray and paint before inserting. In the morning, use hairspray before inserting your lenses. (And to further cut the chance of infection, use only water-based, nongreasy cosmetics.) In the evening, remove, clean and store your lenses before removing your makeup.