Why are the eyes red, watery, itchy and sore?

Turning to ophthalmologists, many patients complain that they have red and teardrop eyes or red eyelids and watery eyes.

When do these symptoms occur, and what if the eyes are watery and red?

Why is the eye red and watery?

It should be noted that there are various external risk factors for eye hyperemia and increased secretion of tear fluid. This is the ingress of dust or smoke into the eyes, the contact effect of detergents or other household chemicals (containing phosphates that cause an allergic reaction of the skin and mucous membranes), and in women - and decorative cosmetics. From overwork of eyes at their long pressure there is a  syndrome of a red eye. And in the elderly and in children often the eyes are watery and red from the cold wind, very bright light or water ingress.

The pathological causes of these symptoms are associated with a number of ophthalmic diseases of an infectious nature.

If the eyelid is swollen, it seems that something has got into the eye, the eye itself is red, it hurts and tears, then most often the first signs of inflammation of its mucous membrane - conjunctivitis - appear. Redness is noted on the tarsal conjunctiva (on the inner side of the eyelids). After a couple of days, the secretions become thicker due to the addition of pus, that is, the eye is red, swollen, watery and festering. By the way, similar symptoms are noted in inflammation of the lacrimal gland (dacryoadenitis).

Depending on the pathogen, conjunctivitis is defined as bacterial (to its development, pneumococci, Staphylococcus aureus, hemophilic rod, moraxella, pseudomonas) or viral (including those caused by the herpes virus) may be involved. And when the red eyes water and runny nose, it is most likely symptoms of the mucous membranes of the nasal cavity, nasopharynx and conjunctiva eye one of the serotypes of the Adenoviridae virus -  adenoviral conjunctivitis. And complaints that in the morning red eyes and watery, can mean the presence of  epidemic hemorrhagic conjunctivitis, which is spread exclusively by contact and at first affects one eye (causing tars and increased reaction to light).

However, the conjunctiva can become inflamed due to the allergic reaction of a systemic nature, which is responsible for the pathogenesis of seasonal allergic conjunctivitis. In such cases, lays the nose, the eyes are red, watery and itchy, swelling of the eyelids is noted.

Also, the eyes strongly water and red in keratoconjunctivitis: when the infection affects not only the conjunctiva, but also the epithelium of the cornea that passes into it. In addition, the cornea can be infected with a water-born amoeba of the genus Acanthamoeba with the appearance of acanthamoe keratitis. According to experts, the risk factors for this disease are corneal damage, in particular, for those who wear contact lenses.

In addition to conjunctivitis, keratitis or dacryoadenitis, red eyelids and watery eyes (often with purulent secretions) in the development of the inflammatory process in the hair bulbs of the eyelashes - blepharitis (or in combination with inflammation - blepharoconjunctivitis), as well as infecting the edges of the meybomic glands (meibomian blepharitis or meybumite).

With hyperemia, ophthalmology and hypersecretion of tear fluid - in other words, if the eye is red, sore and teary - there is a suspicion either of  glaucoma, the pathogenesis of which is associated with increased intraocular pressure, or episcleritis or anterior diffuse  scleritis. Scleritis refers to the inflammation of the outer shell of the eyes (sclera); it can be a bacterial or autoimmune etiology (that is, it can develop in people with rheumatoid arthritis and other autoimmune diseases).

Perirocorneal injection of the vessels of the eyes (i.e., their reddening), tearing, photophobia, blepharospasm and decreased visual acuity manifest inflammations of the choroid of the eyes - uveitis, having a different etiology (infectious, endocrine, autoimmune).

If a child has a red eye and is watering, the causes of these symptoms, as well as the pathogenesis of the diseases causing them, are the same as in adults. Read also -  Why the child has red eyes and what to do?

Pathogenesis

The pathogenesis of the reddening of the eyes arising from the diseases mentioned above is largely explained by the branching of the intertwining blood vessels located in the choroid of the eye (choroid) and having different lumens. It is believed that this reduces the rate of outflow of blood from the capillaries to the venous sinus. In addition, through the walls in the endothelium of the capillary walls, the red blood cells can leave the vessels, promoting hyperemia.

At the same time, the presence of a large number of immune (fat) cells releasing inflammatory mediators, and having Ig receptors (immunoglobulins) on their membranes plays an important role in the reaction of eye tissues during their inflammation.

In keratitis in an inflamed cornea, the multilayered epithelium of which is adapted to rapid regeneration, the process of formation of new blood vessels begins, the filling of which intensifies hyperemia at the onset of the disease.

A hypersecretion of tear fluid has a protective nature - due to the presence in its composition of a hydrolase enzyme lysozyme, which destroys bacteria, that is, it has bactericidal properties. For more details on the pathogenesis of tearing, see the material -  The eyes of an adult and a child

Diagnostics

Diagnosis - taking into account the patient's complaints red eyes, pain and increased lacrimation - should reveal the etiology of this symptomatology.

This may require such tests as a general and biochemical blood test, an antibody test; microbiological examination of the smear of secretions from the eye or cytological examination of corneal scrapings cells.

Ophthalmic instrumental diagnostics - examination with a slit lamp and an onmoscope; (according to the indications) the measurement of intraocular pressure, ultrasound of the eye, retinography, keratotopography, perimetric testing is carried out. For more details see -  Investigation of the eye

Based on the results of the survey, differential diagnosis is performed - to determine the exact diagnosis and the purpose of therapy.

[1], [2], [3], [4], [5], [6], [7], [8], [9]

Treatment

Ophthalmologists know what to do if the eyes are watery and red. Depending on the cause - conjunctivitis, blepharitis, keratitis or scleritis - appropriate medications are prescribed, usually applied locally drops or ointments.

Inflammations of bacterial etiology require the use of antibiotics. For example, the use of Albucid drops (with sodium sulfacil); Brulamycin (with aminoglycoside antibiotic tobramycin); Okokistin (contraindicated in pregnant women and children under three years old); Gatifloxacin (Zimar); Oftadec and Conjunctin (with decamethoxin); Vigamox (with moxifloxacin); Fucitalmic (with fusidic acid). Dosage, contraindications, possible side effects - in the material  Eye drops from conjunctivitis

Possible use of antibacterial eye ointments such as tetracycline, levomycetin, Colbiocin (with chloramphenicol, tetracycline and sodium colistimethate), Maxitrol (with neomycin and dexamethasone).

Also read:  What is conjunctivitis and how to deal with it?

With the virus origin of inflammation, droplets Ocoferon and Ophthalmoferon are used; in cases of conjunctivitis or keratitis caused by herpesvirus, Oftan Idu is instilled (drops with idoxuridine).

With allergic conjunctivitis, antihistamine drops for the eyes are required: Alelastin or Allergoodil (containing azelastine hydrochloride), Cromohexal or Cromopharm (with cromoglycic acid).

When keratitis conjunctivally used regenerating ointment Betamecil, gel with dexpanthenol Korneregel.

In the treatment of scleritis are appointed as local corticosteroids - eye drops Oftan-Dexamethasone or Maxides, hydrocortisone ointment, and systemic (ingested).

Surgery

Eye hyperemia and tearing are symptoms, and surgical treatment may be required if pathologies that require surgery are identified.

For example, it may be a problem with the lacrimal canal, in case of obstruction of which (dacryocystitis), a normal outflow of tear fluid must be surgically performed.

When glaucoma - to remove excess intraocular fluid - resorted to iridectomy, during which a laser makes a microscopic opening, which allows you to reduce the pressure inside the eye.

Alternative treatment

In ophthalmology, alternative treatment is not recommended: unless in the form of compresses that remove itching and swelling from raw grated potatoes or lotions with black tea.

And herbal treatment allows washing the eyes with decoctions of chamomile, chamomile, yarrow, ivan-tea, herb of snake mountaineer, thyme, lapchatka, jasper or leaves of plantain large.

[10]

Consequences and complications

Each pathology, with the development of which the eyes are strongly teary and red, can have certain consequences and give complications.

Thus, conjunctivitis of pseudomonadal and adenovirus origin is most often complicated by keratitis. In turn, inflammation of the cornea is fraught with deterioration of vision, and a violation of its integrity - partial and complete loss of vision.

Also, the consequence of infectious conjunctivitis may be vascular pannus of the cornea - the formation in its surface layer of a clouded area with ingrown blood vessels.

Among the complications of keratitis, there is a transformation of the inflammatory process into a purulent form with the appearance of a corneal ulcer, with perforation of which there are irregularities in the iris (as a pigment dispersion syndrome).

Glaucoma, scleritis and uveitis can lead to blindness.

[11], [12], [13], [14], [15], [16], [17], [18], [19]

Prevention

The main prevention of eye hyperemia and increased lachrymation is observance of hygiene, which will help not to infect the eye. It is especially important to monitor the cleanliness of the hands of children, because - after rubbing the eye with dirty hands - the child carries a huge number of bacteria that can cause inflammation.

And, no matter how trite it does not look, strengthen immunity and in the winter take vitamins.

Forecast

Inflammations of the conjunctiva, tear gland and even the cornea are curable; the progression of glaucoma can be slowed down. It is more difficult to make a prediction about diseases that have an autoimmune etiology, as well as allergic conjunctivitis. In any case, when the eye is red and watery, treatment is necessary. With increased intraocular pressure, it must be urgent to prevent blindness.