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Red, Irritated, Itchy, Watery Eyes: How to Tell If It's Pink Eye or Something Else

For 6 months, I struggled with both recurring pink eye as well as scleritis. I assumed I had seasonal allergies.

Are Your Eyes Making You Miserable?

Are your eyes red, irritated, itchy, watery, crusty, and making you miserable? Learn the difference between pink eye, allergies, and more serious medical problems.

Are your eyes red, irritated, itchy, watery, crusty, and making you miserable? Learn the difference between pink eye, allergies, and more serious medical problems.

Is It Allergies, Pink Eye, or Something More Serious?

Do you see that red, irritated, itchy, watery eye? That's mine on a good day lately. Actually, I have two of them, although one tends to look and feel a lot worse than the other. For six months, I struggled with both recurring pink eye as well as scleritis, a serious eye condition that involves inflammation of the whites of the eyes.

At first, I delayed seeking medical treatment because I assumed I was suffering with seasonal allergies (e.g., tree, ragwood, mold, pollen). But my eyes became so red they looked like demon's eyes, and they hurt intensely—a stabbing pain.

I wondered if it was pink eye or even some small foreign object in my eye, like an eyelash. However, over-the-counter medications and flushing my eyes did not seem to help.

I waited longer than I should have to consult a professional. If you have bloodshot, uncomfortable eyes that are bothering you, I'd like to help you avoid making that mistake by understanding possible causes and knowing when to see your ophthalmologist.

Bloodshot (or red) eyes can have many causes.

Bloodshot (or red) eyes can have many causes.

The Misery of Red, Itchy Eyes

We often take our eyes for granted until something goes wrong.

Your eyes feel red, irritated, itchy, uncomfortable or even painful. Maybe you have crusty discharge or watery eyes that make you look like you're crying. There are a number of potential causes. Could you be suffering from allergies, pink eye, or something more serious?

Ultimately, only an opthamologist can tell you, but here are some common possible reasons for red eyes and associated symptoms.

Why Are My Eyes Red? Common Causes

Source: Mayo Clinic

It Could BeOr ThisOr Even This

allergies or hay fever

foreign object in eye

episcleritis (inflammation of the membrane covering the white part of the eye)

pink eye (conjunctivitis)

blepharitis (inflammation that affects your eyelids)

eye strain

broken blood vessel in eye

glaucoma

corneal abrasion (scratch)

corneal ulcer or corneal herpes infection

chalazion (painless bump or nodule inside the eyelid.

iritis (inflammation of the colored part of the eye)

stye (a red, painful lump near the edge of the eyelid)

eye injury (trauma or burn)

an eyelid that is turned inward or outward

scleritis (inflammation of the white part of the eye)

uveitis (inflammation of the middle layer of the eye)

keratitis (inflammation of the cornea)

dry eyes (decreased tear production)

eyedrops

occular herpes

Moist, Weepy Eyes Are Uncomfortable

Pink eye can be caused by a variety of factors:  viruses, bacteria, allergens, or foreign objects.  The color of the discharge (clear, yellow, or green) can help your doctor discern the likely source of your ailment.

Pink eye can be caused by a variety of factors: viruses, bacteria, allergens, or foreign objects. The color of the discharge (clear, yellow, or green) can help your doctor discern the likely source of your ailment.

Common Causes of Eye Boogers

Source: All About Vision

Description of Eye BoogerPossible Causes

watery

viral conjunctivitis, allergic conjunctivitis, eye allergies, dry eyes, eye injury, blocked tear duct

crusty

blocked tear duct, bacterial conjunctivitis and other eye infections, stye

sticky and gooey

stye, bacterial conjunctivitis and other eye infections, corneal ulcer, blocked tear duct

stringy

dry eyes, corneal ulcer, allergic conjunctivitis, eye allergies

Pink eye can affect one or both eyes and may be highly contagious for up to two weeks after syptoms start.

Pink eye can affect one or both eyes and may be highly contagious for up to two weeks after syptoms start.

Also called conjunctivitis, pink eye involves redness or pinkness of the conjunctivae, the membranes that cover the whites of the eyes and inner eyelids. Pink eye is a common ailment and can be highly contagious.

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Symptoms

This illness is typically transmitted via direct contact with an infected person's eye secretions or bacteria living in the nose or sinuses—a good reason to cover those sneezes, wash those hands, and avoid touching your eyes!

Symptoms of pink eye can include

  • redness in the eye
  • swelling
  • watering
  • gritty feeling and an urge to rub the eye(s)
  • itchiness, irritation and/or a burning sensation
  • discharge that may be green, yellow, or clear
  • eyelid and eyelash crusting, particularly upon waking
  • enlargement or tenderness of the lymph node in front of the ear and
  • contact lenses that do not stay in place on the eye and/or feel uncomfortable.
red-irritated-itchy-watery-eyes-is-it-pink-eye-or-something-else

Causes and Potential Consequences

Pink eye can be caused by a variety of factors, including viruses, bacteria, allergies, and irritants (e.g., a chemical splash, foreign object). Viral and bacteria forms are highly contagious.

Applying a wet compress—a clean, wet washcloth—to the eyes can help alleviate the symptoms of viral or bacteria pink eye. Viral pink eye typically resolves on its own after a week or two. Bacterial pink eye, however, calls for a prescription of antibiotic eye drops.

Potential complications of pink eye may include an inflammation of the cornea which can impair vision. Repeated bouts of pink eye such as the kind I've been having suggest an underlying systemic disease. See an opthamologist if your suspected pink eye persists, if the discharge from your eyes is yellow or green (suggesting bacterial pink eye), or if you are unsure what it might be.

How to Prevent Pink Eye from Spreading

If you suspect you may have pink eye, keep this uncomfortable and potentially very contagious condition from spreading to others.

Here are some helpful tips:

  • Wash your hands frequently
  • Avoid touching the eyes
  • Change pillowcase frequently
  • Avoid shaking hands when you have pink eye
  • Cover coughs and sneezes
  • Avoid sharing towels, washcloths, makeup, eyedrops, handkerchiefs and tissues.

Allergies

If it's allergy season where you live, you may at first assume that's what is wrong with your red, itchy eyes. It's not necessarily the case.

Symptoms of Allergies

As a rule of thumb, allergies carry with them fewer symptoms than infections. These symptoms typically include redness, itching, burning, and a clear watery discharge. (If the discharge from your eyes is anything more than this (e.g., colored, thick), assume an infection.)

With allergies, you may also have symptoms that extend beyond the eyes, such as nasal congestion, a runny or stuffy nose, sneezing, scratchy or sore throat, and a cough from post-nasal drip.

Causes of Allergies

Allergies occur when your immune system recognizes a substance as harmful and overreacts to it. Your environment is filled with potential allergens:

  • Dust mites
  • Pollen from trees, plants, grasses, ragweed, etc.
  • Animal dander
  • Molds
  • Contact lenses and lens solution and
  • Cosmetics.

Symptoms are often alleviated with allergy eye drops, artificial tears, and over-the-counter allergy medications (e.g., Benadryl, Flonase, Claritin, Zyrtec). Sometimes, however, a prescription is necessary, including general allergy medications (e.g., Singular), anti-inflammatory drops, and/or steroids.

Scleritis is an inflammation of the sclera, or whites of the eyes.  The sclera is the tough membrane that forms the outer wall of your eyeball.

Scleritis is an inflammation of the sclera, or whites of the eyes. The sclera is the tough membrane that forms the outer wall of your eyeball.

Scleritis: Inflammation of the Whites of the Eyes

Who knew the whites of your eyes could become inflamed? The sclera is the tough membrane that forms the outer wall of your eyeball.

Symptoms of Scleritis

Scleritis is an uncommon but serious eye disease, and its symptoms include:

  • an angry red color (sometimes with a violet or even blue tinge) affecting one or both eyes; it can be either diffuse or comfined to a pie-shaped area
  • tenderness to the touch
  • blurred vision
  • extreme light sensitivity (photosensitivity)
  • teary eyes (you feel like your eyes are involuntarily leaking) and
  • moderate to severe pain that feels deep and penetrating (a stabbing "ice pick" pain) and may radiate to the face, jaw, and down the neck.
Scleritis feels as bad as it looks.  The redness can be diffuse or concentrated in a pie shape, as in this photo.  Pain is deep and penetrating.

Scleritis feels as bad as it looks. The redness can be diffuse or concentrated in a pie shape, as in this photo. Pain is deep and penetrating.

Causes and Potential Consequences of Scleritis

The cause of scleritis is unknown in about half of all cases. However, the other half of scleritis cases involve a manifestation of a systemic autoimmune condition, including:

  • Sarcoidosis
  • Rheumatoid Arthiritis (RA) and other types of inflammatory arthiritis
  • Lupus
  • Wegener Granulomatosis
  • Syphillis
  • Lyme Disease
  • Mixed Connective Tissue Disease
  • Inflammatory Bowel Disease
  • Sjogren's Syndrome
  • Scleroderma
  • Vasculitis and
  • Tuberculosis.

If you're thinking "I don't have any of these diseases, so I'm fine," then be careful. Scleritis may be the initial symptom, meaning that you don't know you have one of these autoimmune diseases until you are faced with this eye condition. My opthamologist refered me to a rheumatologist for extensive testing for a wide range of conditions, including those above. The results were that I may have lupus.

Potential complications of scleritis include retinal detachment, angle-closure glaucoma, and loss of vision. Don't risk your eyesight. If you are concerned that you may have symptoms of scleritis, see your opthamologist immediately.

Why is my eye red, irritated, and teary?  There are a number of potential causes.  If in doubt, see an opthamologist.

Why is my eye red, irritated, and teary? There are a number of potential causes. If in doubt, see an opthamologist.

Summary of Similarities and Differences: Bacterial and Viral Pink Eye, Allergies & Scleritis

An ophthamologist can examine, diagnose and treat your eye condition. If you have pain, discomfort, changes in vision or color in the eye, consult an ophthamologist promptly.

 Bacterial or Viral Pink EyeSeasonal AllergiesScleritis

Description of condition

A common eye ailment involving redness or pinkness of the conjunctivae, the membranes that cover the whites of the eyes and inner eyelids

A common condition that occurs when the body's immune system recognizes a substance as harmful and overreacts to it. May be chronic or last a long time.

A serious eye disease involving inflammation of the whites of one's eyes. Typically associated with underlying autoimmune conditions.

Affects one or both eyes?

One or both eyes

Both eyes

One or both eyes

Common symptoms

Redness, swelling, watering, grittiness, urge to rub one's eyes, discharge (yellow, green or clear), eyelid crusting upon waking, contact lenses that are uncomfortable or won't stay in place

Redness, itching, burning, clear watery discharge

Moderate to severe pain, redness, tearing, light sensitivity, eye tenderness, decreased visual acuity. Usually no eye discharge.

Painful or merely uncomfortable?

Uncomfortable or mildly painful

Uncomfortable, not painful

Moderately to severely painful; deep, penetrating pain

Common causes

Direct contact with an infected person; touching an item that an infected person has touched then touching one's eyes; poor handwashing

Dust mites; pollen from trees, plants, grasses, and weeds; animal dander; molds; contact lenses and lens solution; and cosmetics.

Half of cases have no apparent cause. The other half are due to underlying systemic diseases such as connective tissue disorders, autoimmune diseases, or vasculitic abnormalities.

Contagious?

Can be highly contagious

No

Typically not

Diagnosis

Exam by opthamologist may include sampling eye discharge for testing

Your family physician or opthamologist may refer you to an allergist who will take your personal and medical history and may perform allergy testing.

Exam by ophthamologist; blood tests for possible underlying medical conditions.

Treatment

Artificial tears; antibiotic eyedrops for bacterial pinkeye or secondary infections caused by scratching; viral pink eye should simply run its course in 1-2 weeks

Allergy drops, artificial tears, and over-the-counter allergy medications,

Specific treatment for underlying autoimmune condition, anti-inflammatory eye drops; NSAIDS, steroids, or immune modulating medications.

Long-term effects

Inflammation of the cornea which can impair vision

If left untreated, severe asthma, sinus problems, headache and gastrointestinal problems may occur.

Must be diagnosed, treated, and monitored by an ophthamologist to avoid long-term vision loss. Retinal detachment and angle-closure glaucoma are possible.

Prevention

Avoid touching the eyes; wash hands; cover sneezes and coughs; don't share items such as makeup, towels, eyedrops

Keep windows closed; use an air purifier/dehumidifier, zippered "allergen-impermeable" covers on pillows and mattresses; wash bedding in hot water weekly.

Generally no prevention. Be aware of any underlying autoimmune conditions.

When Should I Consult an Opthamologist?

An opthamologist can professionally examine, diagnose, and medically treat your eyes if they are red, irritated, itchy, painful, crusty, and watering.

An opthamologist can professionally examine, diagnose, and medically treat your eyes if they are red, irritated, itchy, painful, crusty, and watering.

When to Consult an Eye Doctor (Ophthamologist)

Canadian Ophthamological Society; American Academy of Ophthamology

Seek An Opthamologist If You Have Any of These SymptomsEspecially If You ...

Physical changes to the eye, including crossed, bulging, or misaligned eyes, signs of infection (e.g., swelling, discharge, redness), unequal pupil size

Have a history of high intraoccular eye pressure

Pain in the eye

Have had a previous eye injury or are already experiencing eye conditions such as cataracts, glaucoma, macular degeneration, etc.

Changes in vision such as double vision, flashes of light, sudden spots, jagged lines or lightning streaks, wavy lines, haloes around lights

Are living with diabetes, HIV/AIDS, thyroid disease, rheumatological diseases such as lupus, or other immune compromising illnesses.

Loss of vision in one or both eyes, changes in color vision

Are of Hispanic or African descent

Changes in the field of vision, including shadows, black spots or blurriness, shadows, curtain-like loss of vision

Have a family history of glaucoma, cataract, macular degeneration, or retinal detachment

 

Are taking medications that can impact vision (e.g., Plaquanil, Prednisone, Ethambuto, many others)

 

Family members or others in close associate with you have the same symptoms (suggests contagion)

Help your doctor diagnose your condition by providing a precise and accurate description of what you are experiencing.  This will help you get on the path to recovery.

Help your doctor diagnose your condition by providing a precise and accurate description of what you are experiencing. This will help you get on the path to recovery.

4 Key Things to Tell Your Eye Doctor

When you call your eye doctor about red and irritated eyes, offer the following information so they can help triage you:

  1. Symptoms: Redness in one eye or both? Pain or mere discomfort? Clear, yellow, green, and/or crusty discharge? Tearing? Itchiness? Changes in vision?
  2. When your symptoms started
  3. Anything you've tried, such as over-the-counter medications, compresses, eyedrops
  4. Any associated medical conditions that you know of (e.g., autoimmune diseases)? Previous eye injury or conditions? History of high intraoccular pressure?

Providing a precise description of your problem will help you get an immediate appointment, if needed. It will assist the opthamologist in the diagnosis and treatment of your condition.

The world is looking better now!

The world is looking better now!

Sources

8 Ways to Get Rid of Dust Mites - MedicineNet. (2011, April 11). Retrieved from http://www.medicinenet.com/script/main/art.asp?articlekey=20276

Boyd, K. (2015, March 1). What Is Scleritis? - American Academy of Ophthalmology. Retrieved from https://www.aao.org/eye-health/diseases/what-is-scleritis.

Centers for Disease Control. (2016, June 30). Conjunctivitis. Retrieved from https://www.cdc.gov/conjunctivitis/index.html.

Dahl, A. A. (2017, April 7). Scleritis Treatment, Symptoms, Causes & Risk Factors. Retrieved from http://www.medicinenet.com/scleritis/article.htm#scleritis_facts.

Gans, R. (2016, November 9). Itchy, Red Eyes? How to Tell If It's Allergy or Infection. Retrieved from https://health.clevelandclinic.org/2016/11/itchy-red-eyes-how-to-tell-if-its-allergy-or-infection/.

Mayo Clinic Staff. (2016, February 26). Red eye causes - Mayo Clinic. Retrieved from http://www.mayoclinic.org/symptoms/red-eye/basics/causes/sym-20050748.

Medical Definition of Pinkeye. (2016, May 13). Retrieved from http://www.medicinenet.com/script/main/art.asp?articlekey=11886.

National Institutes of Health. (2015, November). Facts About Pink Eye | National Eye Institute. Retrieved from https://nei.nih.gov/health/pinkeye/pink_facts.

Smith, J. R., Mackensen, F., & Rosenbaum, J. T. (2007). Therapy Insight: scleritis and its relationship to systemic autoimmune disease. Nature Clinical Practice Rheumatology, 3(4), 219-226. doi:10.1038/ncprheum0454

Surtenich, A. (2016, November). Eye discharge - causes, types, treatment. Retrieved from http://www.allaboutvision.com/conditions/eye-discharge.htm.

This content is accurate and true to the best of the author’s knowledge and does not substitute for diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed health professional. Drugs, supplements, and natural remedies may have dangerous side effects. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.

Questions & Answers

Question: I have one eye that is a little red. It itches, and is watery and swollen around the eye. What can I take?

Answer: Until you can contact your ophthalmologist (eye doctor), you might try over-the-counter artificial tears or allergy drops with redness reducer. You can get them at any drug store, grocery store, or Walmart. If you're really itchy, you might try oral Benadryl. Do not touch your eyes even though they itch, never share eye drops, and wash your hands frequently.

In the article, there's a table ("Why Are My Eyes Red? Common Causes") that you should take another look at. It's a good reminder that while your ailment hopefully is something minor, it could potentially be any number of things. I know it's a weekend now, but first thing on Monday, please contact your eye doctor if the problem persists. You don't want to risk your vision. If you feel it's an emergency, contact them now. You don't want to assume that you know what this is. My father, for example, had a small foreign object in his eye that he didn't know was in there. He waited longer than he should have to see an eye doctor and found that he had suffered scratching to his cornea. As a reminder, I am not an eye doctor. Please take care of yourself.

© 2017 FlourishAnyway

Comments

FlourishAnyway (author) from USA on April 20, 2020:

Peggy - Thanks for the pin. Sometimes you think you know what something is but it's more serious! The eyes are nothing to fool around with.

Peggy Woods from Houston, Texas on April 19, 2020:

What you wrote is important information to share with others. I'll be pinning this to my health board. Having an annual eye exam is also important even if not having any symptoms. Many health concerns can be diagnosed and addressed early because of eye exams.

FlourishAnyway (author) from USA on January 20, 2018:

Marylou - You might try going back to the family doctor or see another opthamologist. I had to see two opthamologists because the first one did not properly treat my condition. Err on the side of caution. Eyesight is too important.

Marylou Beeson on January 19, 2018:

I was having some discomfort in both of my eyes. I did go to an eye Dr. but he didn't find any thing. The discomfort continued . A couple of months later I had a bad cold, cough, chest congestion. Then one day I looked in the mirror and my eyes were puffy and reddened. I got in to see my family Dr. , he said it appeared to be a bacterial infection and prescribed antibiotic eye drops 2 in each eye every 6 hours. It did seem to clear up, but I still have some of my discomforts.