Red eye in adults

Red eye in adults is a common condition that can result from a variety of causes, ranging from benign to serious. Below is a comprehensive overview of the potential causes:

Common Causes

1. Conjunctivitis (Pink Eye):
   • Viral Conjunctivitis: Often associated with upper respiratory infections, highly contagious.
   • Bacterial Conjunctivitis: Caused by bacteria such as Staphylococcus or Streptococcus, often with purulent discharge.
   • Allergic Conjunctivitis: Triggered by allergens like pollen, dust, or pet dander, often accompanied by itching and watery discharge.
2. Subconjunctival Hemorrhage:
   • Description: Broken blood vessels under the conjunctiva, often appearing as a bright red patch.
   • Causes: Trauma, coughing, sneezing, straining, or hypertension.
3. Dry Eye Syndrome:
   • Description: Insufficient tear production or poor tear quality.
   • Symptoms: Redness, burning, itching, and a gritty sensation.
4. Blepharitis:
   • Description: Inflammation of the eyelid margins.
   • Symptoms: Redness, itching, and crusting of the eyelids.

Inflammatory Causes

1. Uveitis:
   • Description: Inflammation of the uveal tract (iris, ciliary body, and choroid).
   • Symptoms: Redness, pain, photophobia, and blurred vision.
   • Causes: Autoimmune diseases, infections, or idiopathic.
2. Scleritis:
   • Description: Inflammation of the sclera.
   • Symptoms: Severe pain, redness, and possible vision loss.
   • Causes: Autoimmune diseases like rheumatoid arthritis or infections.
3. Episcleritis:
   • Description: Inflammation of the episcleral tissue.
   • Symptoms: Mild pain, redness, and irritation.
   • Causes: Often idiopathic, but can be associated with systemic inflammatory conditions.

Infectious Causes

1. Keratitis:
   • Description: Inflammation of the cornea.
   • Symptoms: Redness, pain, photophobia, and blurred vision.
   • Causes: Bacterial, viral (e.g., herpes simplex), fungal, or parasitic infections.
2. Orbital Cellulitis:
   • Description: Infection of the tissues surrounding the eye.
   • Symptoms: Redness, swelling, pain, fever, and possible vision loss.
   • Causes: Bacterial infection, often secondary to sinusitis.

Traumatic Causes

1. Corneal Abrasion:
   • Description: Scratch on the cornea.
   • Symptoms: Redness, pain, tearing, and photophobia.
   • Causes: Trauma, foreign bodies, or contact lens misuse.
2. Chemical Burns:
   • Description: Exposure to harmful chemicals.
   • Symptoms: Redness, pain, tearing, and possible vision loss.
   • Causes: Alkali or acid exposure.

Vascular Causes

1. Acute Angle-Closure Glaucoma:
   • Description: Sudden increase in intraocular pressure.
   • Symptoms: Severe eye pain, redness, blurred vision, halos around lights, nausea, and vomiting.
   • Causes: Blockage of the aqueous humor drainage.
2. Carotid-Cavernous Fistula:
   • Description: Abnormal connection between the carotid artery and the cavernous sinus.
   • Symptoms: Redness, proptosis (bulging eye), and bruit (whooshing sound).
   • Causes: Trauma or spontaneous.

Systemic Causes

1. Hypertension:
   • Description: High blood pressure can cause red eye due to vascular changes.
   • Symptoms: Often asymptomatic but can cause subconjunctival hemorrhage.
2. Autoimmune Diseases:
   • Description: Conditions like rheumatoid arthritis, lupus, or Sjögren’s syndrome can cause red eye.
   • Symptoms: Vary depending on the underlying condition.

Evaluation and Diagnosis

When evaluating red eye in adults, healthcare providers consider several factors:

• Duration and Onset: Acute vs. chronic.
• Associated Symptoms: Pain, vision changes, discharge, systemic symptoms.
• Medical History: Trauma, contact lens use, systemic diseases.

Diagnostic Tests:

• Slit-Lamp Examination: Detailed examination of the anterior and posterior segments of the eye.
• Intraocular Pressure Measurement: To rule out glaucoma.
• Fluorescein Staining: To detect corneal abrasions or ulcers.
• Blood Tests: To check for systemic infections or autoimmune conditions.
• Imaging: CT or MRI for suspected orbital cellulitis or carotid-cavernous fistula.

Conclusion

Red eye in adults can be caused by a wide range of conditions, from benign to serious. A thorough clinical evaluation, including history, physical examination, and appropriate diagnostic tests, is essential to determine the underlying cause and guide treatment. Adults experiencing persistent or severe red eye should seek medical attention to ensure proper diagnosis and management.

For more detailed information, consulting a healthcare provider or referring to medical literature is recommended.