Whether it’s a lack of sleep
or swimming in a chlorinated pool, it’s usually obvious why your eyes are
giving you trouble.
But sometimes what seems
a routine annoyance could point to a deeper problem. Here, Angela Epstein
reveals the potential causes of your eye symptoms...
RED EYES
Cold sore: Viruses or localised infections can cause the
eye to redden — the problem usually starts in one eye, but can spread to both.
The cold sore virus, which 90 per cent of us carry, can sometimes also infect the eye, causing inflammation. Other symptoms of an eye infection include throbbing pain around your eye, sensitivity to light, (photophobia) and a watery eye. You may need antiviral drops or ointment from your GP. If you have a cold sore on your mouth, always wash your hands after touching it.
The cold sore virus, which 90 per cent of us carry, can sometimes also infect the eye, causing inflammation. Other symptoms of an eye infection include throbbing pain around your eye, sensitivity to light, (photophobia) and a watery eye. You may need antiviral drops or ointment from your GP. If you have a cold sore on your mouth, always wash your hands after touching it.
Iritis: If the eye turns a deep red and you have
throbbing pain at the front, this could be iritis or anterior uveitis — inflammation
of the iris, the coloured part of the eye. This is triggered by an
over-reaction of the immune system, though its exact cause isn’t known. The
redness tends to start at the centre of the eye and spreads in a red ring
around the centre within 24 to 48 hours. It doesn’t usually spread to the other
eye. Treatment initially involves corticosteroid eye drops, though if there is
infection, you may need antibiotics.
High blood pressure: Persistent red blotches on the whites of
both eyes can be a sign of hypertension, explains Ian Grierson, professor of
ophthalmology at the University of Liverpool. High pressure causes the
blood vessels to expand or even burst, leaving red marks across the white of
the eye (but not the coloured part).
Haemorrhage: If one eye suddenly becomes red without
any other symptoms, then it could be a subconjunctival haemorrhage — where
blood leaks in the thin layer of skin at the front of the eyeball. This is
very common, particularly in older people. It can be brought on by a violent
coughing fit, vomiting, or if you are prone to nose bleeds or bruising. It
should clear up by itself within a couple of weeks, says Professor Grierson.
DRY EYES
The menopause: This causes changes in hormone levels,
affecting, among other things, the lubrication mechanisms of the eye, says
David Allamby, an ophthalmic surgeon and medical director of the Focus Laser
Eye Clinic in London. There is less fluid for the tear film which washes over
the surface of the eye — so leading to dry eyes. To tackle the problem,
close your eyes for 20 seconds every ten minutes, suggests James Ball,
consultant ophthalmic surgeon at St James’s Hospital in Leeds. Working in
an air-conditioned office, or leaving contact lenses in for too long can also
cause dry eyes (air conditioning is drying, while contact lenses absorb a lot
of moisture in the eyes).
If you need eye drops
for dry eyes — known as artificial tears — choose a brand without the preservative
benzalkonium chloride, which can cause irritation, says Andrew Lotery,
professor of ophthalmology at the University of Southampton. ‘You tend to find
it in eye drops that come in bottles,’ he says. Most eye drops
contain preservatives to inhibit bacteria because they are used again and
again. Eye drops without preservatives come in one-dose tubes — once
they’re opened, they should be used up or thrown away after one day. As well as
using eye drops, dry eyes can be helped by taking a supplement of omega 3,6 and
9.
Sjogren’s syndrome: An auto-immune condition affecting around half a
million people in the UK, this causes the body to attack its own
moisture-producing glands, leading to abnormal dryness of the eyes, says Mr
Allamby. Other symptoms include extreme dry mouth and muscle fatigue. The
slow-onset condition affects women more than men, and is typically diagnosed in
your 40s and 50s. The symptoms can be eased with artificial tears.
Exposure keratitis: Here the cornea, the dome at the front of
the eye, has become dry. It can be caused by not closing the eyes properly
during sleep. ‘You wouldn’t notice this yourself, but a loved one might,’ adds
Mr Ball. Other causes include injury to the eye or not blinking enough
which leads to dryness of the cornea. Treat with artificial tears.
ITCHY EYES
Blepharitis: This is an irritation and infection of the skin
of the inner eye lids, and affects millions of people in the UK. Sometimes
flakes appear on the eyelids which look like dandruff but are actually flakes
of skin from the eyelid. It can be caused by a bacterial infection, but is
also associated with rosacea, a skin condition which causes the face to redden,
explains Robert Scott, consultant ophthalmologist at the NHS Birmingham and
Midland Eye Centre and the BMI Priory Hospital, Birmingham.
There’s no cure for
blepharitis — Mr Scott advises treating it by putting a tiny pinch of
bicarbonate of soda in an cup of hot water, dipping in a cotton wool bud and
then running this along the eye lash margin. Do this twice a day to reduce
irritation.
Allergy: Itchy eyes are often a symptom of
allergies, a problem known as allergic conjunctivitis. There are two
types: seasonal allergic conjunctivitis (which typically happens because of
exposure to grass, pollen, trees and weeds), and perennial allergic
conjunctivitis (which happens all year long due to the exposure to household
allergens such as mould, dust and pet hair). Symptoms may subside when away
from the cause. Antihistamines and steroid nasal sprays can often control the
eye symptoms.
COLOURED RINGS ROUND
THE IRIS
High cholesterol: A milky-white ring around the iris can be a sign
of high cholesterol. Known as arcus senilis, this white ring is caused by
the deposition of fat in the cornea, the clear area at the front of the eye,
explains ophthalmic surgeon Oliver Backhouse, of the Yorkshire Eye Hospital.
The ring should disappear with treatment and lifestyle changes. Not everyone
with high cholesterol will develop this symptom.
Wilson’s disease: A coppery-coloured ring round the eye can
be a sign of Wilson’s disease, a rare genetic disorder which causes too much
copper to build up in the body. Untreated it can cause damage to the liver and
brain. Treatment is through medication and avoiding foods with a high
concentration of copper such as liver, chocolate, nuts and mushrooms.
WATERY EYES
Blocked tear ducts: If the tear ducts are blocked, this means fluid
can’t drain away. As the fluid stagnates, it can lead to infection and a sticky
discharge in the duct, making the eyes water. You may also develop a painful
swelling on the side of the nose next to the eye. The problem is more
common with age, because collagen — a protein in skin — can shrink within the
tear duct, blocking it off, says David Allamby. It can also be caused by a
cold. If the problem is caused by a chronic blockage, a common option is
surgery.
Dry eyes: Dry eyes can also cause watery eyes. When
eyes are dry, this acts as an irritant, which will produce watering.
DROOPY EYE
Cysts: Another potential cause of a droopy eye is
a large, internal cyst which is not necessarily painful, says Mr Scott. Known
as a chalazion, it is caused by a blockage of one of the oil glands in the eye.
Fluid can’t drain properly, so it builds up to form a smooth pea in the eyelid.
Hot compresses can soothe the area and may help the duct drain. Sometimes,
chalazions need to be surgically removed. Always see your doctor to have it
checked out.
Diabetes: Drooping can sometimes be a sign of
muscular problem or nerve damage elsewhere in the body, says Mr Scott. ‘Diabetes
can damage the fine blood vessels that support the nerves at the back of the
eye. However, if it comes on suddenly, it could be a caused by a small aneurysm
(bulge in a blood vessel) in the brain, a brain tumour or a tumour on the top
of the lung, so seek medical attention immediately.’
EYE PAIN
Scratch to the eye: A corneal abrasion, as it is known, causes a
very sharp pain and instinctively the eye lid will close to protect the cornea
from bright light says Mr Backhouse. These kinds of injury usually heal by
themselves, although antibiotic eye drops from your pharmacist can prevent
further infection. If you are still in pain after a week, see your GP.
Ulcer: A corneal ulcer can cause a sharp, constant pain
in the eye but also make the brightness of the eye look dull. The ulcer itself
can look like a speck of cottage cheese. The condition mostly affects
contact lens wearers, as these might cause a slight breach on the surface of
the cornea when inserted and removed, but ulcers can also be the result of an
eye infection. It is important to get help quickly — treatment involves antibiotic
drops or steroids — to avoid damage.
Glaucoma: A deep-boring pain can be a sign of glaucoma,
which occurs when the eye’s drainage tubes become blocked, explains Mr Ball.
This tends to affect the elderly, particularly women — there are around 500,000
cases in the UK — ‘but only half are diagnosed because they don’t go to the
opticians regularly,’ he says. Left untreated it can lead to blindness.
Drugs such as prostaglandin analogues increase the flow of fluid out of your
eye, while beta blockers can reduce fluid production.
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