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Bloodshot Eyes – Should You Be Concerned?

You wake up in the morning ready to start your day, only to discover that your eyes are bloodshot. That might not be surprising if you stayed up late to finish a project, had too many drinks at a party or spent time in a smoke-filled room.

But bloodshot eyes can also signal an underlying eye problem. If your eyes appear red or bloodshot, make an appointment with an optometrist for a comprehensive eye test to determine the cause and to receive effective treatment.

Why Do I Have Bloodshot Eyes?

When blood rushes to the front of the eye, the tiny red blood vessels on the white of the eye dilate and become visible. This makes the eyes appear red and irritated.

So why do these blood vessels dilate, causing your eyes to look bloodshot?

Bloodshot eyes tend to be caused by:

  • Dry eyes
  • Irritants such as smoke, pollen and perfume
  • Lack of sleep
  • Excessive alcohol consumption
  • Spending too much time in front of the computer

Bloodshot eyes due to lifestyle and environmental irritants may disappear on their own, or you can try to relieve them with over-the-counter eye drops or liquid tears. Lifestyle changes, such as getting more sleep, cutting down on alcohol intake and limiting screen time can often be helpful. If allergies are the culprit, oral antihistamines and antihistamine eye drops may relieve symptoms.

At other times, underlying problems requiring prompt medical attention can cause your eye’s blood vessels to dilate. The following are some of these medical conditions:

Conjunctivitis

You’ve probably heard of “pink eye.” It’s another name for infectious conjunctivitis – an infection of the conjunctiva, the thin membrane covering the eyelid and the front surface of the eye.

There are two types of infectious conjunctivitis – bacterial and viral.

If your child has conjunctivitis, they’re not alone. About 12% of kids get bacterial conjunctivitis every year. This highly contagious condition affects children and adults. In addition to reddish eyes, the following symptoms are associated with conjunctivitis:

  • Bacterial conjunctivitis – irritated eyes, swollen eyelids, eye discharge, crusty eyelids and excessive tearing
  • Viral conjunctivitis – cold or flu-like symptoms, runny nose, fever, itchy eyes, excessive tearing

If you or your child are experiencing these symptoms, it’s important to schedule a prompt appointment with an optometrist, who can diagnose whether the conjunctivitis is viral, bacterial or due to allergies.

Depending on the diagnosis, your optometrist will prescribe antibiotic eye drops or creams to treat bacterial conjunctivitis. The viral form may run its course after a few days, but cold compresses and non-prescription eye drops may provide relief.

Dry Eye Syndrome

If your eyes are chronically bloodshot you may have dry eye syndrome (DES). Signs of DES include:

  • Dry, irritated eyes
  • Burning or stinging eyes
  • Discharge from the eyes
  • Light sensitivity
  • A feeling you have something stuck in your eyes
  • Blurred vision
  • Watery eyes

Dry eye syndrome is most commonly caused by a blockage of the tiny meibomian glands in the eyelids. These glands secrete oil that keeps eye moisture from evaporating too quickly. Without the oil, tears dry fast, leaving your eyes feeling dry, itchy and with a bloodshot appearance.

Too much screen time, aging, certain medications such as antihistamines, and medical conditions such as Sjogren’s syndrome can cause dry eye syndrome.

In addition to any medications or in-office treatments your optometrist recommends, make sure to get plenty of hydration, take frequent breaks from digital screens and use a humidifier in your home.

Uveitis

In addition to bloodshot eyes, if you also experience blurred vision, see floaters or your eyes feel painful, you may have an eye inflammation called uveitis. The causes of uveitis include:

  • Autoimmune or inflammatory condition
  • Infection
  • Medication side effects
  • Cancer (in rare cases)

Unfortunately, uveitis symptoms can often be mistaken for something less serious. That’s the reason it’s important to get an eye test if your eyes are bloodshot. Left untreated, uveitis can lead to serious conditions such as retinal scarring, cataracts and vision loss.

Depending on the cause and severity, your optometrist may treat uveitis with prescription eye drops, steroid pills, injections or eye implants.

Eye Injury

It’s vital that all eye injuries receive immediate eye care from an optometrist.

Even a minor eye injury can cause a big red blotch to form on the white part of the eye (sclera). The cause is a broken blood vessel or a subconjunctival hemorrhage.

Although the appearance of this blood looks severe, and can make the entire white part of the eye appear bright red, a subconjunctival hemorrhage is usually painless and doesn’t cause vision loss. Any time you notice excessive blood on the eye following an eye injury, schedule an appointment with an optometrist to assess the health of your eye.

Glaucoma

In rare cases, bloodshot eyes may signal the presence of glaucoma – a leading cause of vision loss and blindness.

While some types of glaucoma don’t show symptoms in the early phases, bloodshot eyes can indicate the type of glaucoma that requires immediate medical care. This disease causes damage to the optic nerve due to excessive pressure within the eye. When this pressure suddenly rises, the eye’s blood vessels become dilated and visible, making the eye appear red.

If you have bloodshot eyes and/or have the following risk factors for glaucoma, immediately schedule an appointment with your optometrist.

  • Family history of glaucoma
  • Aged 60+
  • African American, Asian or Hispanic
  • Diabetes
  • High blood pressure

Bloodshot Eyes Won’t Go Away?

Talk to Us Any time you notice bloodshot eyes or blood on the front of the eye, don’t wait. Schedule your eye test with Joe Chen at Rowville Eyecare in Rowville today.

Q&A With Your Local Optometrist

Can I get bloodshot eyes after LASIK surgery?

LASIK surgery is highly effective minimally invasive laser eye surgery that can correct refractive errors, but like all surgical procedures, it can have side effects. Your eyes may be bloodshot or you could see halos from a few days to three weeks after surgery. Additionally, you may experience other dry eye symptoms. Eye drops and liquid tears can alleviate these symptoms, but if you have any concerns about your eyes following LASIK surgery contact your eye surgeon.

What Should I Expect from a Glaucoma Exam?

If you have a family history and/or other risk factors for glaucoma, and if your eyes look bloodshot, consider scheduling a glaucoma exam. Your optometrist may perform the following tests:

  • Tonometry – eye pressure test
  • Gonioscopy – to see how fluid is draining out of your eye
  • Vision field test – to examine the functioning of the optic nerve
  • Dilated pupil exam – to detect any damage to the optic nerve
  • Retinal photo or OCT – digital examination of the retina and optic nerve health

How Sleep Apnea Affects The Eyes

Did you know that some eye conditions are associated with sleep apnea? According to the National Sleep Foundation, more than 18 million Americans have sleep apnea, and Health Canada reports similar prevalence. It’s a sleep disorder where people stop breathing — often multiple times per night — while sleeping.

If you have sleep apnea: it tends to take longer for your tears to be replenished, you’re more likely to have ocular irritation, you have a higher chance of developing floppy eyelids, and you’re at increased risk for glaucoma.

What Is Obstructive Sleep Apnea?

There are different types of sleep apnea. The most common one is obstructive sleep apnea (OSA). During OSA, your airway becomes partially blocked due to relaxed muscles in your nose and throat. This causes apnea (the absence of breathing) or hypopnea (abnormally shallow, slow breathing). It’s twice as common in men, and is more likely to affect people with obesity, hypertension, diabetes or heart disease.

What are the common symptoms of sleep apnea?

Sleep apnea occurs when the muscles in the back of your throat relax too much to allow normal breathing. These temporary breathing lapses cause lower-quality sleep and affect the body’s oxygen supply, which can lead to potentially serious health consequences.

While snoring is a common symptom, not everyone who snores has sleep apnea. Interrupted sleep can cause excessive daytime sleepiness, fatigue, irritability or depression, headaches in the morning, difficulty concentrating and thinking, and a sore throat.

Which Eye Conditions Are Associated With Sleep Apnea?

Glaucoma

Glaucoma occurs when increased pressure within the eye damages the optic nerve, which connects the eye to the brain, leading to vision loss and sometimes blindness. In some cases, it might be due to a drop in blood oxygen levels, which happens when you stop breathing. However, CPAP machines, one of the most common treatments for sleep apnea, can also cause glaucoma.

So, people with sleep apnea — even if it’s being treated — need to get their eyes checked on a regular basis for glaucoma.

Floppy Eyelid Syndrome

Floppy Eyelid Syndrome (FES) is an eye condition where a person has an unusually large and floppy upper eyelid. It can cause eye redness, irritation, discharge, or blurry vision — and over 90% of people with FES also have sleep apnea.

Non-Arteritic Anterior Ischemic Optic Neuropathy

Non-arteritic anterior ischemic optic neuropathy (NAION) is an eye condition that occurs when there is a loss of blood flow to the optic nerve. Patients typically complain of significant vision loss in one eye without any major pain. Approximately 70-80% of patients with NAION have been found to have OSA.

Retinal Vein Occlusion

Also referred to as an ‘eye stroke,’ retinal vein occlusion (RVO) is a blockage of the small veins that carry blood away from the retina. A recent study of 114 RVO patients found that sleep apnea was suspected in 74% of the patients that had previously been diagnosed with RVO.

Other Eye Health Issues Associated With Sleep Apnea

Some other ocular conditions that are more common in patients with sleep apnea include: papilledema, keratoconus and central serous chorioretinopathy. Furthermore, in addition to glaucoma mentioned above, CPAP machines are associated with dry eye syndrome and bacterial conjunctivitis.

Talk To Your Doc

Get eye exams regularly to rule out eye disorders and prevent potential vision loss, especially if you have been diagnosed with sleep apnea. At Rowville Eyecare in Rowville we encourage you to share your medical history with us so we can better diagnose and treat any eye conditions or ocular diseases you may have, and help you keep your eyes nice and healthy.