Eye - Red or Painful

Is this your symptom?

  • Red or pink color of the white part of the eye(s)
  • Eye may be painful
  • May have increased tears (watery eye)
  • If the symptoms are caused by an injury, see the Eye Injury care guide.

Causes of Pinkeye (Red Eye)

  • Pinkeye Defined. When the white of the eye becomes pink or red, it's called pinkeye. Conjunctivitis is the medical name for pinkeye. It becomes pink or red when it is infected or irritated. Pinkeye has many causes.
  • Viral Pinkeye is the main cause of pink or red eyes without pus. Most often, it is part of a cold.
  • Bacterial Pinkeye. Pinkeye, plus the eyelids are stuck together with pus. Most likely, this is a secondary infection of viral conjunctivitis.
  • Allergic Pinkeye is from pollens. It causes red, itchy and sometimes gritty eyes. Most people with eye allergies also have hay fever. Symptoms include sneezing and clear nasal discharge. Easy to treat with eye drops.
  • Irritant Pinkeye from sunscreen, soap, chlorine in pool water, smoke, or smog. Irritants can also be transferred by touching the eye with dirty fingers. Irritants can be food or plant resins.
  • Contact Lens Pinkeye is caused by poor use of disinfectant solution or lenses kept in too long or overnight.
  • Eye Drop Abuse often happens when people use daily OTC eye drops to remove mild redness. After the medicine wears off, the blood vessels become larger than they were to begin with. Similar to the rebound nasal congestion seen in chronic nose drop abuse.
  • Dry Eye Syndrome happens when not enough tears are made by the eye. The eyes feel gritty and painful, but are not red. It is more common with age. It can be caused by medicines or other health problems. Pinkeye with pus can be common with dry eyes.
  • Broken Blood Vessel in Eye may be from an injury or coughing, or due to raised blood pressure. It can also happen with no known cause. It will look like blood in part or all of the eye. It does not change your vision and is often painless. Goes away on its own in about two weeks. It may turn yellow before going away. Go to the ER if the blood vessel breaks from a hard hit.
  • Foreign Object. If only one eye has pinkeye, an object in the eye must be considered.
  • Palpebral Cellulitis (serious). A bacterial infection of the eyelids and skin around them. Causes the lids to be very red and swollen.

Causes of Eye Pain

  • Quick Onset Glaucoma (serious) happens when the normal flow of fluids in the eye is blocked. Pressure builds up in the eye that can cause long-term vision loss. Symptoms include pain that starts quickly, seeing haloes around lights, light bothers your eyes, watery eyes and headache. Get these symptoms checked right away. More common in people older than 50 years of age.
  • Keratitis is inflammation of the cornea. It can be caused by an injury, wearing contacts or past eye infection. Symptoms are eye pain and redness; vision can be affected. Needs care right away.
  • Scleritis (serious) feels like severe, dull eye pain which may spread to the jaw or forehead. Light may bother the eyes. You may notice changes in vision. More common in people 50 years or older who have other health problems.
  • Endophthalmitis (serious) feels like a painful, red eye and poor vision after a surgery or injury to the eye. May also be linked to drug use or a weak immune system. Needs to be treated by a doctor right away to save the eye.
  • Photokeratitis and Snow Blindness are like having a sunburn of the cornea (the front clear part of the eye). The eyes can be very painful and it may be hard to keep them open. Eye drops may be needed to help with the pain. Sunglasses and goggles can keep the eyes safe from these types of injuries.

When to Call for Eye - Red or Painful

When to Call for Eye - Red or Painful

Call Doctor or Seek Care Now

  • Eye pain and you are more than 50 years old
  • Eye pain or discomfort is more than mild
  • Eyelid is very red or very swollen
  • Blisters or pain of the skin in the eye area
  • Fever or chills; feeling hot or shivery
  • Eye pain or redness following recent surgery or trauma
  • Weak immune system. Examples are: sickle cell disease, HIV, cancer, organ transplant, taking oral steroids, diabetes, kidney problems.
  • Nonstop tears or blinking
  • Headache
  • You feel weak or very sick
  • You think you need to be seen, and the problem is urgent

Contact Doctor Within 24 Hours

  • Eye redness or pain lasts more than 24 hours
  • You take a blood thinner
  • You think you need to be seen, but the problem is not urgent

Contact Doctor During Office Hours

  • Redness lasts more than 7 days
  • Sudden onset of redness, but no pain. Looks like blood in the white part of the eye. Exceptions: no vision change and not taking blood thinners.
  • You have other questions or concerns

Self Care at Home

  • Red eye is part of a cold
  • Red eye is caused by mild irritant (such as soap, sunscreen, food, smoke, chlorine in a swimming pool)
  • Red eye from wearing contact lenses too long (improves when lenses are left out)

Call Doctor or Seek Care Now

  • Eye pain and you are more than 50 years old
  • Eye pain or discomfort is more than mild
  • Eyelid is very red or very swollen
  • Blisters or pain of the skin in the eye area
  • Fever or chills; feeling hot or shivery
  • Eye pain or redness following recent surgery or trauma
  • Weak immune system. Examples are: sickle cell disease, HIV, cancer, organ transplant, taking oral steroids, diabetes, kidney problems.
  • Nonstop tears or blinking
  • Headache
  • You feel weak or very sick
  • You think you need to be seen, and the problem is urgent

Contact Doctor Within 24 Hours

  • Eye redness or pain lasts more than 24 hours
  • You take a blood thinner
  • You think you need to be seen, but the problem is not urgent

Contact Doctor During Office Hours

  • Redness lasts more than 7 days
  • Sudden onset of redness, but no pain. Looks like blood in the white part of the eye. Exceptions: no vision change and not taking blood thinners.
  • You have other questions or concerns

Self Care at Home

  • Red eye is part of a cold
  • Red eye is caused by mild irritant (such as soap, sunscreen, food, smoke, chlorine in a swimming pool)
  • Red eye from wearing contact lenses too long (improves when lenses are left out)

Care Advice

Treatment for (Viral) Red Eye Infections

  1. What You Should Know About Red Eyes:
    • Some viruses cause red, watery eyes.
    • There are a small number of serious causes which need urgent treatment.
    • It may simply be the first symptom of a cold. Colds can cause a small amount of mucus or pus in the corner of the eye.
    • If serious causes are ruled out, you can treat this at home.
    • Here is some care advice that should help.
  2. Eyelid Rinse:
    • Cleanse eyelids with warm water and a clean cotton ball. Wash your hands first. Use warm water and wet cotton balls to clean the eye gently. Throw the cotton ball away after use. Use a new cotton ball for each eye.
    • Try to do this 3 times a day.
    • This usually will keep a bacterial infection from occurring.
  3. Artificial Tears:
    • Artificial tears often make red eyes feel better. No prescription is needed.
    • Use 1 drop per eye 3 times a day as needed. Use them after cleansing the eyelids.
    • Antibiotic and vasoconstrictor eye drops do not help viral eye infections.
  4. Eye Drops: How to Use
    • Gently pull down on the lower lid. Put 1 drop inside the lower lid. Then close the eye for 2 minutes. Reason: allows time for the medicine to get into the tissues rather than run out of the eye.
    • Another option is to lie down. Put 1 drop over the inner corner of the eye. If you open the eye or blink, the eye drop will flow in. If you don't open the eye, the drop will slowly seep into the eye anyway.
    • Avoid touching the eye or tissues around the eye with the end of the dropper.
    • Throw the drops away when no longer needed.
  5. Contact Lenses:
    • If you wear contact lenses, you should switch to glasses until the infection is gone.
    • Reason: to prevent damage to the cornea.
    • Make sure you disinfect the contacts before wearing them again.
    • Discard them if they are disposable.
  6. Return To Work:
    • You do not need to miss any work.
    • Avoid anything that may irritate your eyes, such as swimming, until the infection is gone.
  7. What to Expect:
    • Pinkeye with a cold usually lasts about 7 days.
    • Sometimes, it turns into a bacterial eye infection. You can tell because the eyelids will become stuck together with pus.
    • Pinkeye from an irritant usually goes away within 2 hours after the irritant is removed.
  8. Call Your Doctor If:
    • You get a large amount of pus in the eye
    • Redness lasts more than 1 week
    • You think you need to be seen
    • Your symptoms get worse

Treatment for Mild Eye Irritants

  1. What You Should Know About Pinkeye from Irritants:
    • Most eye irritants cause redness of the eyes. The eyes may also water a lot.
    • It will often go away on its own once the irritant is removed.
    • You can treat that at home.
  2. Face Wash:
    • Wash the face with mild soap and water.
    • This will remove any irritants still on the face.
  3. Eyelid Rinse:
    • Rinse the eyelids with warm water for 5 minutes.
    • You can do this with clean cotton swabs soaked in water.
  4. Eye Drops:
    • Red eyes from irritants usually feel much better after being washed out.
    • If eyes remain red and feel irritated, you can use some artificial tears.
    • Dose: 1 drop, 3 times per day, as needed.
    • A vasoconstrictor eye drop (such as Visine) can also be used. No prescription is needed.
    • Dose: use 1 drop. May repeat once in 8 to 12 hours. Never use for more than 3 days.
    • If you are not sure what to use, as a pharmacist.
    • Always follow the advice on the package.
  5. What to Expect:
    • After the irritant is removed, the eyes usually return to normal color.
    • This may take 1 to 2 hours.
  6. Prevention:
    • Try to avoid future contact with the irritant.
  7. Call Your Doctor If:
    • A large amount of pus in the eye occurs
    • Redness lasts more than 7 days
    • You think you need to be seen
    • Your symptoms get worse

And remember, contact your doctor if you develop any of the 'Call Your Doctor' symptoms.

Disclaimer: this health information is for educational purposes only. You, the reader, assume full responsibility for how you choose to use it.

Copyright 2023 Schmitt Decision Logic LLC.

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