The Philippine Online Chronicles

If you see a person like this blogger wearing shades in a dark internet café, what is the first thought that comes to your mind?  A. The person is trying to be cool; B. The person is a fugitive hiding from the law; or C. The person has “sore eyes.”

While you may hope the person is just trying to be cool and not letter B, more often than not, people who wear shades in the most unusual places are forced to do so because of sore eyes.

What exactly is “sore eyes”?

The most common cause of sore eyes, also called “red eye” or “pink eye,” is conjunctivitis.

In the Philippines, “sore eyes” usually refers to viral conjunctivitis. This may be accompanied by other symptoms like tearing (nagluluha), discharge (nagmumuta), swollen eyelids (namamaga ang mata), itchiness (nangangati), glare (nasisilaw, hence, the shades), foreign body sensation (puwing), and sometimes even pain or blurring of vision.

Anyone of any age and status can get sore eyes - from children like Aiden (who was only 10 weeks old when he first had it), Gracie (who is a little older), and Adam (who also had concomitant colds and ear infection) to adults like Gloria Macapagal-Arroyo.

The common causes of conjunctivitis are either a viral or bacterial infection, allergy, or chemical irritation.  It’s important to know the causes because there are different ways to treat this problem and it all depends on the cause.

Despite the usual belief, one does not get sore eyes from simply looking or staring at the eyes of an infected person.

Types of conjunctivitis

Allergic conjunctivitis is caused by being exposed to an allergen – the trigger for an allergic reaction.  It may be dust, pollen, food, or whatever you have an exaggerated reaction to.  The main symptom is itching.  Treatment usually consists of cold compresses and antihistamines in either eye drop or oral forms.

For chemical conjunctivitis, the affected person usually has a history of exposure to the fumes of a chemical, or sometimes to the chemical itself.  If there is a history of being in contact with the chemical itself, the patient’s eye should immediately be flushed with running water (sterile if possible but any running water in an emergency) and should be brought immediately to the ophthalmologist or at least to the emergency room for immediate evaluation, because some chemicals, particularly strong acids and alkalis, could cause a lot of damage to the eye.

Infectious conjunctivitis (either viral or bacterial) is usually transmitted through direct contact with the infectious material such as eye discharge and tears.

There are a few types of bacterial conjunctivitis which are sexually transmitted, like gonorrhea or Chlamydia, or acquired by passing through the birth canal, as in the case of newborns.  Gonorrhea deserves special mention, because untreated gonorrheal conjunctivitis could lead to blindness.

Viral or bacterial conjunctivitis may be associated with other systemic conditions like colds and fever.

The importance of hand washing

If a person who is infected touches his eye, his hands and fingers pick up the microbe.  Whatever he touches next (whether it’s another person’s hands or something inanimate like a doorknob, pen, or phone that somebody else may use later) will temporarily hold the microbes.

That is why hand washing is very important in preventing transmission to other people.  If you have sore eyes, be sure to wash or sanitize hands every time you touch your eyes.  Instead of a handkerchief or a towel, use tissue paper to wipe tears or discharge so that you can dispose of it afterwards.

Treatment of conjunctivitis

Most cases of viral conjunctivitis are self-limiting, much like the common cold.  Bacterial conjunctivitis, however, requires antibiotic eye medications which are targeted against the causative germs.

Do not self-medicate with eye drops or ointments, especially those which contain steroids, as these should be prescribed by an ophthalmologist.

As much as possible, stay home and take a leave from work to lessen the chances of transmitting the virus and also allow you to rest and recover.

You can apply cold compresses to relieve the symptoms.  Lubricant eye drops (available over-the-counter at major drug stores) may also help.  But avoid eye drops which promise to lessen the redness.  These contain vasoconstrictors, which make the blood vessels look smaller, making the eyes appear less red.  However, the effect is only temporary and would not help to make the condition better.  You may even get “rebound congestion” when you use it too often or too long.

Going natural

Some people use human breast milk as a treatment for sore eyes. This does no harm and might actually help because of the immunoglobulin component which may help fight off the infection. Some people swear that it works.  If you want to try this, be sure that the breast milk is collected under sterile conditions – if possible, just squirt directly from the breast into the eye, rather than risk contamination from unsterilized collecting containers. Another home remedy involves a fresh fruit diet.  Neither of these are endorsed by the medical community, but these may not do harm if you try them.

Other home remedies, which may or may not work, include the use of honey, aloe vera juice, calendula, and cool tea bags. These are not recommended by conventional medicine, however, so try at your own risk. Oh, and if you’ve heard of the practice of using urine to treat “sore eyes,” please don’t even try it.

If symptoms become worse or the condition doesn’t clear up, have a checkup with the ophthalmologist.

Other causes of eye redness

Not all cases of eye redness are caused by conjunctivitis.  Other causes of eye redness include blepharitis, keratitis, uveitis, acute angle closure glaucoma, corneal abrasions, foreign bodies, chemical burns or subconjunctival hemorrhage, and many more.

These other problems are treated differently from conjunctivitis.  Hence, it’s important to know what the underlying problem for the eye redness is, so that correct treatment may be instituted.

While red eye is a relatively common problem and does not cause long-term complications in most cases, it is important to get to the real cause of the problem.  Blindness is an uncommon but real risk if the wrong diagnosis is made and improper treatment is instituted.

Photos: “Sunglasses at Night” by Jon, c/o Flickr. Some Rights Reserved / “øjenbetændelse” by , c/o Flickr. Some Rights Reserved / “Swollen eye with conjunctivitis” by Tanalai at en.wikipedia This file is licensed under the Creative Commons Attribution 3.0 Unported license. / “Subconjunctival hemorrhage” by Elias Punch, c/o Flickr. Some Rights Reserved.