Red, Itchy and Watery Eyes?

  Do you suffer from red, intensely itchy and watery eyes?  If you do, then you probably have eye allergies.  Your symptoms may run concurrently with a runny nose and you may blame it on a “cold” you keep getting when in fact you have allergies and don’t know it.

How do you know it is not pink eye or dry eyes?  Patients with pink eye report some itching.  Those with eye allergies describe intense itching.  Pink eye, which is usually caused by a bacteria or virus, typically starts in one eye and affects the other eye (although not as badly) after a few days.  By contrast, eye allergies involve both eyes from the beginning.

Bacterial pink eye causes a yellowish discharge and your eyelids may be stuck together in the morning.  Bacterial pink eye is most common in infants and toddlers whose immune systems are not yet fully developed, and in those with compromised immune systems, such as seniors.  Viral pink eye is generally accompanied by a watery discharge and other signs on the eye surface, such as follicles (or dendrites in the case of herpes viral infections that affect the eyes), that can be used by an optometrist or ophthalmologist to differentiate it from the bacterial form. Viral pink eye is the most common conjunctivitis seen in school-aged children.  Viral pink eye may also affect the lymph nodes.  More often than not, those with viral pink eye have been recently ill with an upper respiratory infection.

Both bacterial and viral pink eye are highly contagious and can be transmitted by contact with family or friends with recent pink eye.

The hallmark of eye allergies, on the other hand, is profound or intense itching causing the patient to rub his or her eyes very frequently and occasionally even with the knuckles.  This is not to be confused with dry eyes, where the patient may experience some minor itching,  but dry eyes typically present as a foreign body sensation, burning, grittiness and tearing and the eyes are not as red as they are with eye allergies or pink eye.  Dry eyes and eye allergies may go hand in hand — if you have dry eyes, then you don’t produce enough tears to flush out the allergens in your eyes, which may lead to eye allergies.  In such cases, your eye doctor may need to treat your dry eyes in order to treat your eye allergies.  If you have allergies or dry eyes, and you wear contact lenses, your best option is 1-day disposables.

Contact lens related red eyes are usually caused by poor contact lens hygiene and compliance, overuse of contact lenses, sleeping with contact lenses and allergic reactions to contact lens solutions.

Inflammatory conditions such as iritis or an auto-immune disorder such as rhuematoid arthritis etc. can also cause red eyes.

Often, patients see an optometrist or ophthalmologist for red or intensely itchy and watery eyes only after trying (unsuccessfully) over-the-counter eye drops.  However, over-the-counter eye drops will not treat bacterial or viral infections of the eyes, including herpes viral eye infections and chlamydia bacterial eye infections.  It is also important to be aware that some over-the-counter eye drops have vaso-constrictors in them: vaso-constrictors reduce redness by constricting the blood vessels in the eyes.   Although eyes may appear to be less red, the eye drops may not be treating the cause of the redness.  Further, sustained use of vaso-constrictors can actually cause rebound hyperemia — chronic red eyes.

Anti-histamines, such as Claritin and Allegra, may help with eye allergies but they also dry up eye tissue, causing dry eyes.

Eye allergies that lead to vigorous eye rubbing is not a good thing because there is an association between vigorous eye rubbing and a condition called keratoconus, a degenerative disorder of the eye in which structural changes within the cornea cause it to thin and become more conical in shape.

In conclusion, red eyes can be caused by:

  • Infection – bacteria and viruses.
  • Non infection – allergies and dry eyes
  • Improper use of contact lenses and contact lens solutions
  • Inflammation

The importance of seeing an optometrist or ophthalmologist for professional diagnosis and treatment cannot be over-emphasized.  An optometrist or ophthalmologist can prescribe drops that can provide relief from the symptoms of eye allergies within 3 minutes! OR, prescribe drops for bacterial ,  some viral infections of the eye, dry eyes or eye inflammations should that be the case.

So if you have red, intensely itchy and watery eyes, you now know that it may be allergies and not that same cold you keep getting.

Meyer Izaac, O.D.


About Meyer Izaac, O.D.

I am an optometrist in Encino, Ca. I love what I do and I like practicing on a very personal basis without feeling rushed so that I can provide the highest standards of optometric care and address my patient's needs in an orderly manner. I received my Bachelor of Science at Indiana University in Bloomington, Indiana, and my Doctor of Optometry at the Southern California College of Optometry in Fullerton, California where I graduated with honors. My services include comprehensive eye examinations for glasses and contact lenses, eye disease diagnosis and management including glaucoma, and refractive surgery consultation and co-management. I am licensed to prescribe therapeutic medications for the treatment and management of eye infections, glaucoma, inflammation, eye allergies and dry eyes. I have a particular interest in specialized contact lens fittings such as keratoconus, orthokeratology, post corneal transplants and post refractive surgeries as well as other hard to fit contact lens cases. I strive to achieve excellence in providing thorough patient examination and recommendations.!/Izaaceyes .
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4 Responses to Red, Itchy and Watery Eyes?

  1. Pingback: How Would You Treat A Red-Eye? | Meyer Izaac, O.D.

  2. Don Strode says:

    Viral infections can cause some unexplainable rash which can go away anytime. .

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  3. Raymon Massey says:

    For the most part, antihistamines are safe. Having said that, antihistamines can have side effects which, if the antihistamine is not properly administered, can be serious. The truth is, all medications have side effects. Some are mild, as in the case of an aspirin, unless you have stomach ulcers or aspirin sensitivity and others are more serious such as the side effects from chemotherapy, but for the most part, antihistamine side effects are fairly mild. The newest antihistamines are probably about the safest medications that there are. But there are differences between the various antihistamines and their side effects.`

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  4. Reena Fesenbek says:

    Eye allergies, while generally not life-threatening, can be a real nuisance. Red, itchy eyes can make it difficult to work, drive or read, since our natural inclination is to rub irritated eyes, we usually only make the problem worse because of our frustration. But relief is now available for eye allergies with Patanol eye drops, an antihistamine prescription medication that can be ordered easily and conveniently from online pharmacy –

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