3 reasons your eyes are red (and what to do about it)

Eye Care

by Baylor Scott & White Health

Jan 12, 2015

No one likes a case of red-eye, but is there ever a reason to worry? Here’s a closer look at common reasons your eyes might be red and some eye care advice.

William White, OD, an optometrist with Baylor Scott & White Medical Center – Temple, said red eyes are typically caused by one of three main factors:

  1. Infection, typically a virus or bacteria
  2. Environment, such as allergies, a lack of sleep, or exposure to irritants
  3. Systemic, typically decreased tear production due to aging or systemic inflammation such as lupus or rheumatoid arthritis (both can cause chronic dryness and inflammation)

“The red appearance is caused by enlargement, or dilation, of the blood vessels, typically in a tissue called the conjunctiva,” Dr. White said. “Occasionally, a blood vessel will break and can cause the pooling of the blood between the layers. Thankfully, this is not usually a problem. It just takes a week or two to slowly clear, and no treatment is needed.”

Identifying the cause of red eyes

Your optometrist will usually begin the quest to uncover the cause of redness with a medical history and questions about your daily living. Be sure to mention your medications and environment.

For example, whether you spend a lot of time outdoors or your days inside an office will play a role. Someone who is constantly exposed to wind and dust will likely have a different cause for their redness than a person who works in an office.

Questions may include:

  • How often are your eyes red?
  • Is the redness in one or both eyes?
  • Is there pain or itching?
  • Does anything seem to make it worse or better?

Armed with the answers, your provider may look into your eyes and surrounding tissue.

Treating red eyes

Consider the following when treating red eyes. Your next steps will vary based on what’s causing your eyes to be red and how your symptoms manifest.


For red itchy eyes caused by allergies, Dr. White recommends over-the-counter medicines. These drops work best if they are started about a week before allergy season and continued each day until the allergen is no longer active. It also helps to avoid your triggers, like staying indoors when the pollen count is highest.


Artificial tears work well if the cause is dryness or exposure to something such as wind or dust. Dr. White typically advises using eye drops a few times a day. Putting the drop in the refrigerator can also provide extra relief but is not always necessary.


Cold compresses can provide relief for red, swollen eyes. You can use a cold washcloth or ice pack as needed but for no longer than 10 minutes at a time.

Redness relieving eye drops, usually made from decongestants, may temporarily get rid of redness, but ophthalmologists recommend they only be used occasionally and for a short time. Or opt for preservative-free lubricating eye drops instead.

Using a red-eye-drop doesn’t treat the cause and, in some cases, can worsen the problem.

“These drops constrict the blood vessels and may reduce redness but don’t address the reason for the redness,” Dr. White said.  “Using these drops can cause the eye to become redder because your blood vessels will become accustomed to the drug. Once it wears off, the vessels will rebound and become enlarged or dilated and red again.”

Talk to your optometrist

Always consult your optometrist before starting a new eye drop to ensure it is right for you.

Red eyes are usually a temporary symptom, so if the redness persists, be sure to see your eye doctor for the proper care.

Find a doctor near you to solve your red-eye woes.

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