Why are my eyes red? Here are 3 reasons (and what to do about it)

Many of us have red eyes for a day or two following a few nights of little sleep or seasonal allergies, but sometimes red eyes last longer than that. Is there ever a reason to worry about your eyes being red?

Here’s a closer look at what causes red eyes and some eye care advice to keep your eyes healthy and bright.

What causes red eyes?

Red eyes are caused by enlargement, or dilation, of the blood vessels, typically in a tissue called the conjunctiva (the mucous membrane that covers the front of the eye and lines the inside of the eyelids).

Occasionally, a blood vessel will break and can cause pooling of the blood between the layers. Thankfully, this is not usually a problem. It just takes a week or two to slowly clear, and no treatment is needed.

But what are the underlying reasons for red eyes? There are three main culprits:

1. Infection: Usually from viruses or bacteria
2. Environment: Such as allergies, lack of sleep, ceiling fans, CPAP use or exposure to irritants
3. Systemic: Typically decreased tear production due to aging, systemic inflammation such as lupus or rheumatoid arthritis (both can cause chronic dryness and inflammation) or side effects from medications and other medical treatments

Identifying the cause of red eyes

If you’re having red eyes beyond a day or two, you should consult with your doctor or specialist—either an ophthalmologist or an optometrist. A specialist will usually begin the quest to uncover the cause of redness with a medical history and questions about your daily life.

Be sure to mention any medications you’re taking and any environmental factors that might be important to know.

For example, whether you spend a lot of time outdoors or your days inside an office will play a role. Someone who is constantly exposed to wind and dust will likely have a different cause for their redness than a person who works in an office.

Questions that your provider may ask include:

• How often are your eyes red?
• Is redness in one or both eyes?
• Is there pain or itching?
• Does anything seem to make it worse or better?

Armed with the answers, your provider may look into your eyes and surrounding tissue.

Treatment for red eyes

Fortunately, treatment for red eyes is typically simple and can be done at home in many cases. Consider the following when treating red eyes. Your next steps will vary based on what’s causing your eyes to be red and how your symptoms appear.

Allergies

For red, itchy eyes caused by allergies, identifying the trigger for the allergy and avoidance works best. If necessary, you may take over-the-counter medicines, typically eye drops, including preservative-free artificial tears. These drops work best if they’re started about a week before allergy season and continued each day until the allergen is no longer active.

Dryness, wind or dust

If you have red eyes from dryness or exposure to wind or dust, artificial tears work well. Using tears on a regular schedule works best to prevent dryness but can be used more often as needed. Putting the drop in the refrigerator can also provide extra relief but is not always necessary.

Swelling

Cold compresses can provide relief for red, swollen eyes. You can use a cold washcloth or gentle ice pack as needed but for no longer than 10 minutes at a time.

Redness-relieving eye drops, usually made from decongestants, may temporarily get rid of redness, but ophthalmologists recommend they only be used occasionally and for a short time. Or opt for preservative-free artificial tears instead.

If the drops aren’t working, it’s important to talk to your doctor or specialist. Eye drops constrict the blood vessels and may reduce redness but don’t address the underlying reason for the redness. And sometimes, using these drops can cause the eye to become redder because your blood vessels will become accustomed to the drug. Once it wears off, the vessels will rebound and become enlarged or dilated and red again.

Bottom line: Why are my eyes red?

Red eyes often clear up quickly with a little rest, eye drops and allergy relief. But if you’re dealing with persistent red eyes, it’s a good idea to talk to your doctor or eye specialist.

Always consult your provider before starting a new eye drop to ensure it’s right for you or if what you’ve used in the past isn’t working.

Red eyes are usually a temporary symptom, so if the redness lingers, be sure to see your eye doctor for proper care.

When to seek care

• Persistent redness in the eyes
• Worsening vision
• Eye pain

Find a doctor near you to support brighter, healthier eyes.