Conjunctival Hyperemia: Definition, Symptoms, Causes and Treatment

It is a medical condition in which the whites of the eyes are characterized by high redness.

What happens is that the blood vessels in the eyes dilate, hence the characteristic appearance.

Symptoms 

In addition to the characteristic redness, these are the most common symptoms associated with conjunctival hyperemia:

  • Pain in the eye
  • Blurred vision or loss of vision.
  • Increased sensitivity to light (photophobia).
  • There are systemic symptoms in acute cases (suggestive of infection) (swollen lymph nodes, fever, nausea, and vomiting).
  • Green areas, purulent in case of bacterial infection.
  • Watery discharge if the leading cause is an allergy (associated with watery eyes and nasal congestion).
  • The facial rash could also be present in case of infection or allergies.
  • Sensitivity to the palpation of the eyes or the eye may be challenging to touch (eyelids closed).
  • Significant differences in eye pressure ( glaucoma in one eye).
  • The sensation of having something in the eye (patients describe this sensation as “sand” or “dust” in the eyes).
  • Severe stabbing sensation (acute glaucoma).
  • White infiltrate under the corneal epithelium (infection).
  • Inflammation of the eyelid margins ( blepharitis ).
  • Dry eye, with reduced production of tears.
  • Diffuse or limited inflammation of the sclera.

Causes

These are the most common causes that lead to the appearance of conjunctival hyperemia:

  • Exposure to irritants (chemicals, dust, waste).
  • Conjunctivitis.
  • Trauma or injury.
  • Endogenous eye health problems (suggestive of systemic disease).
  • Inflammation of the sclera of the eye (scleritis or episcleritis) – This leads to the dilation of the blood vessels in the eye and is commonly associated with autoimmune disorders, such as rheumatoid arthritis.
  • Keratitis – Most commonly caused by a bacterial or viral infection. Associated risk factors include contact lens wear, eye trauma, corneal surgery, and reduced immunity.
  • Intraocular inflammation.
  • Subconjunctival hemorrhage.
  • Sepsis (especially if systemic symptoms are present).
  • Systemic autoimmune disorders: such as ankylosing spondylitis and connective tissue diseases ( systemic lupus erythematosus, rheumatoid arthritis, Sjogren’s syndrome ).
  • Medication: such as blood thinners (aspirin, warfarin ).
  • Intraocular surgery.
  • Wear contact lenses.
  • Glaucoma (with or without increased intraocular pressure).
  • Corneal abrasion.
  • Infectious corneal ulcer.
  • Blepharitis (inflammation of the eyelid margins, caused by bacterial infection, most common: staphylococcus).
  • Anterior uveitis (inflammation of the anterior eye segment): its causes are associated with infectious microorganisms, autoimmune disorders, exposure to toxic substances, cancer, trauma, or injury.
  • Chemical burns – cause rapid penetration of the chemical into the cornea.

Other conditions:

  • Cancer (sebaceous cell carcinoma).
  • Amylose.
  • Occupational or environmental factors.
  • Foreign bodies in the eye.

Treatment

These are the most effective treatment measures recommended for conjunctival hyperemia:

Compresses

  • Cold compress: recommended to relieve symptoms caused by eye allergies or in case of inflammation.
  • Hot compress: recommended in patients with red eyes due to blepharitis (more excellent hygiene for faster recovery).

Eye patching

It is recommended to be used as a protective measure in case of corneal abrasion.

 

Removal of the eye patch is possible when the condition improves.

  • Double-eye patch + low light medication + pain reliever: treatment protocol for corneal burns caused by intense or prolonged exposure to UV rays.
  • Eye patches: not recommended in patients diagnosed with infectious conjunctivitis.

Removal of foreign bodies (visible to the naked eye)

Before removing the foreign body, a local anesthetic will be removed.

  • Antibiotic ointment: reduces the risk of secondary bacterial infections.
  • Elimination of the medication that caused the eye to turn red: The patient should speak with the doctor about the possibility of using another similar medication, one that does not have such side effects.

Antihistamines

It is recommended in case of allergies. Available for oral and topical administration.

Other eye allergy medicine includes:

  • Topical vasoconstrictors.
  • Mast cell stabilizers (cromolyn).
  • Topical corticosteroid ointments.
  • Steroid drops.

Protective sunglasses

Recommended measure for those who suffer from dry eye syndrome.

In case of chemical exposure

  • Irrigation with saline solution (high amounts).
  • Pain management (depending on pain intensity, narcotics, or non-steroidal anti-inflammatory drugs).

Antibiotics

Recommended for acute cases of bacterial conjunctivitis.

Available for oral and topical administration.

  • Broad-spectrum antibiotics (gentamicin, tobramycin) are generally prescribed.
  • Severe cases: topical administration of fluoroquinolones ( ofloxacin, ciprofloxacin).
  • Antibiotic eye drops: for persistent or recurrent cases of conjunctivitis.

Gotas Miotic

It is recommended for acute glaucoma.

Conclusions

As you have seen, conjunctival hyperemia can be caused by acute or chronic conditions. Recognizing the early signs and symptoms of different conditions is essential to prevent the more severe complications over time (vision loss, chronic glaucoma).

It is also essential to understand that many external factors can cause such problems, such as airborne allergens, occupational or environmental exposure to different toxins, etc.

If you work in an environment with a high risk of exposure to chemicals or toxic substances, you should wear protective equipment. Do not take chances and think that such things will not happen to you. It is better to protect yourself; it is often easier to prevent than treat.