Red Eyes: The Warning Sign You Shouldn’t Ignore – Corneal Ulcers & More
- Red, irritated eyes are a common complaint, often dismissed as tiredness or screen fatigue.
- Initially attributing her eye irritation to prolonged computer use, she tried over-the-counter eye drops for weeks.
- Corneal ulcers often begin as a scratch or minor injury that becomes infected by microorganisms, explains Jaclyn Pugh, an optometrist at The Optical People and Dry Eye Wales.
Red, irritated eyes are a common complaint, often dismissed as tiredness or screen fatigue. But sometimes, that discomfort signals a more serious problem: a corneal ulcer. These open sores on the cornea – the clear front surface of the eye – can be excruciatingly painful and, if left untreated, can lead to permanent vision loss.
Katie Lester, 34, learned this the hard way. Initially attributing her eye irritation to prolonged computer use, she tried over-the-counter eye drops for weeks. When her left eye became bloodshot, gritty and increasingly sensitive to light, she finally sought professional help. The diagnosis: a corneal ulcer. “I was shocked – and terrified,” Lester said.
Corneal ulcers often begin as a scratch or minor injury that becomes infected by microorganisms, explains Jaclyn Pugh, an optometrist at The Optical People and Dry Eye Wales. “The longer ulcers are left to thrive on the cornea, the harder they become to treat.” Severe, untreated infections can lead to a hole developing in the cornea, allowing infection to enter the eyeball, potentially causing irreversible vision loss, warns Badrul Hussain, a consultant ophthalmic surgeon at Moorfields Eye Hospital.
Lester’s initial treatment with chloramphenicol ointment was successful, but she experienced a flare-up six weeks later, discovering she had developed ulcers in both eyes. Further investigation revealed she had marginal keratitis, an inflammatory condition often linked to blepharitis (inflammation of the eyelids). This condition can disrupt the natural oils that protect the eye, making it vulnerable to infection.
While contact lens wearers are at increased risk – particularly those who reuse lenses or sleep in them – anyone can develop a corneal ulcer. Open-water swimming also elevates risk due to potential exposure to infection-triggering organisms. Any contact lens wearer experiencing red, painful eyes, persistent light sensitivity, vision changes, or white spots on the cornea should seek immediate medical attention, according to Mr. Hussain.
However, infection isn’t the sole cause. Inflammation, severe dry eye, or blepharitis can also contribute to ulcer development. In Lester’s case, her ulcers stemmed from inflammation related to blepharitis.
Recognizing the warning signs is crucial. Beyond redness, look for a foreign body sensation, excessive watering, and aching rather than simple soreness, says Mr. Hussain. Severe eye pain, especially if accompanied by nausea, vomiting, or seeing halos around lights, could indicate a more urgent condition like acute angle-closure glaucoma and requires immediate emergency care.
Even seemingly minor eye irritation shouldn’t be ignored. While red eyes can result from common issues like screen time – which reduces blink rate and leads to dry eyes – or allergies, persistent or worsening symptoms warrant a professional evaluation.
A burst blood vessel in the eye, while alarming in appearance, is usually not a cause for concern, explains Mr. Hussain. However, pain or vision changes accompanying a burst vessel should prompt a medical visit.
Protecting your eyes involves more than just addressing immediate discomfort. Pugh emphasizes the importance of careful cosmetic product selection. “These products are often oil-based and can seriously interfere with the meibomian glands [the glands in our eyelids which release the oils that help our eyelid slide over the eye on a blink].” Blocked meibomian glands can lead to irritation, inflammation, and even more serious conditions like conjunctivitis or uveitis.
Pugh also advises caution with waterproof makeup removers, which can strip the eye of its natural protective oils. She recommends gentle cleaning solutions like hypochlorous acid, a naturally occurring substance that helps maintain eyelid and lash health. This is particularly important for those who wear false eyelashes, which can harbor bacteria.
Lester now incorporates several preventative measures into her routine, including daily eyelid cleaning with special wipes, massage around her eyes to unclog glands, and wearing moisture chamber glasses – similar to ski goggles – in windy conditions. She even wears them when opening the oven to avoid irritation from hot air.
“It’s painful,” Lester says. “When I have a flare-up, I have pain, severe sensitivity to light, red, watering eyes – and struggle with screen time even at the lowest brightness. I do still get ulcers and will get them for the rest of my life, as unfortunately this condition is not curable, it just has to be managed and treated when it flares-up. I thought red eyes were common and nothing to worry about. In fact, they were a sign of something that could have led to me losing my sight – I’d advise anyone not to ignore them.”
– The case of Katie Lester serves as a stark reminder: red eyes are not always harmless. Prompt attention to persistent or worsening symptoms can protect your vision and prevent a potentially devastating outcome.