Everything you ever wanted to know about sore eyes (but were too busy rubbing them to ask)

Everything you ever wanted to know about sore eyes (but were too busy rubbing them to ask)

If your eyes feel worse as the day wears on, you may have dry eyes. Photograph: Terry Vine/Getty Images/Blend Images

Why are my eyes itching?

Itchy eyes are a common sign of tiredness, but if your eyes are often pink and itchy, your eyelids are raw and your eyelashes are crusty, you could have blepharitis. This is a common condition that causes inflammation of the eyelids, including the skin, lashes and meibomian glands (the little structures that make the oily stuff in tears; if tears were too watery, they would evaporate instantly, rather than lubricating the surface of the eye).

Anyone can develop blepharitis, but the peak age is in your 50s. Half of all those with the condition also have dry-eye syndrome, in which the tears don’t do their job properly; the film of tears may be unstable or evaporate too readily. If your eyes feel worst in the morning, after a night’s sleep has allowed secretions to build up, it is likely that you have blepharitis. But if your eyes feel worse as the day wears on, you are more likely to be suffering from dry eyes.

Optometrists can help

Daniel Hardiman-McCartney, clinical adviser for the College of Optometrists, says blepharitis can be a “relentless source of sore eyes, blurry vision and discomfort. I would recommend anyone who thinks they may have it visit their optometrist for advice.”

There is generally no cure, but the condition can be managed. By assessing the eyelids and tear film, your optometrist will be able to recommend a treatment plan, including lubricating eye drops. In most cases, your eyes will become more comfortable, less red and clearer within two to four weeks.

Should I stop using a computer?

When we stare at screens, we blink less often than normal. Tears on the surface of the eye have longer to evaporate, so the eyes get dry and may feel gritty and sore. You should notice a big improvement if you go on holiday and don’t use a screen. If there is a clear correlation, you can use lubricant eye drops and limit screen use, ensuring employers follow Health and Safety Executive advice. Evaporation of tears also increases in a strong wind, smoke or dry, air-conditioned air.

Kelly Plahay of the Eyecare Trust says: “Making simple adjustments to your seat, screen settings or posture could be all that is needed to save your eyes from feeling tired and irritated after a long day at work. Staring at a screen can also highlight existing vision problems, so it is vital that computer users have regular eye examinations and follow a healthy eyecare regime.”

How can I prevent my eyes from drying out?
Sore eyes may develop after you start new medication, if you have become unwell or if you have started wearing contact lenses. Reduced tear production can be a result of ageing, or a side-effect from certain medication, including the pill, antihistamines and antidepressants.

It can also occur because of long-term health conditions such as diabetes and thyroid problems, or because of damage from contact lenses or laser surgery for eyesight.

There is no single explanation for blepharitis. Contributing factors include infection with staphylococcal bacteria, an underlying skin condition such as seborrhoeic dermatitis or rosacea and abnormalities of the meibomian glands. Tiny demodex skin mites living on the eyelid margins can block the glands with their waste products.

How can I control it?

The key to managing blepharitis is eyelid hygiene. First, avoid or remove mascara and eyeliner. Next, apply a warm compress (such as a face flannel) to closed eyelids for 5-10 minutes to melt oils that have built up, then rub closed eyelids up and down and side to side with fingers to loosen crusts. Finally, use a cloth or cotton bud with diluted cleansing solution (such as a drop of baby shampoo in a pint of boiled water, allowed to cool before use) to wipe away gunge from the eyelid edges. Do this twice a day until the symptoms are under control. Ophthalmologist Jeremy Joseph says: “Once the blepharitis subsides, try to keep the hygiene regime going once or twice a week to prevent a recurrence.”

Cleansing eye wipes are a handy in an emergency, but may not be as effective. Regular lubricating eyedrops and occasional antibiotic drops or ointment can help. There is some evidence to support the use of oral fish oil supplements (omega-3-acid ethyl esters 2g, three times a day). An ophthalmologist may prescribe anti-inflammatory steroid or ciclosporin drops in more severe cases. Community optometrist Dr Scott Mackie says tea-tree oil mixed with olive oil by an experienced optometrist is useful in treating demodex mites.

Can a gadget help my dry eyes?

Hi-tech options include devices such as LipiFlow, which work by warming and compressing the eyelids. LipiFlow is a plastic cup with a small, heated plate that presses on the eyelid to clear debris. Experts say there is not enough evidence to recommend such devices, although they are unlikely to cause harm.

What else could it be?
Sore, red eyes are commonly due to conjunctivitis – inflammation of the thin layer covering the front of the eye, usually caused by infection or allergy. If both eyes are red and sore with a watery discharge, it is probably a viral infection such as the common cold. If only one eye is affected and it is sticky with pus, the cause is bacterial; antibiotic eye drops will help.

Red, itchy eyes with no discharge or pus that start in the hay fever season, with other symptoms such as sneezing, are caused by an allergy to pollen. Avoidance of the triggers, wearing sunglasses, taking antihistamines and using eye drops should ease symptoms. Allergies to makeup, hair and skincare products and exposure to fumes can make eyes sting and water. Foreign bodies, including contact lenses, may damage the eye’s surface and cause pain and visual disturbance. Any unexplained visual loss or pain in the eye needs urgent medical attention. theguardian.com

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