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    Eye Problems, Noninjury

    Eye Problems, Noninjury

    Topic Overview

    Many people have minor eye problems, such as eyestrain, irritated eyes, or itchy, scaly eyelids ( blepharitis ). These problems may be ongoing (chronic) but usually aren't serious. Home treatment can relieve the symptoms of many minor eye problems.

    See a picture of the eye .

    Common eye problems

    Common types of eye problems include:

    It is common for the eyes to be irritated or have a scratchy feeling. Pain is not a common eye problem unless there has been an injury. It is not unusual for the eyes to be slightly sensitive to light. But sudden, painful sensitivity to light is a serious problem that may mean glaucoma or inflammation of the muscles that control the pupil ( iritis ) and should be evaluated by your doctor.

    Sudden problems such as new vision changes, pain in the eye, or increased drainage are often more serious and need to be evaluated by a doctor. Eye symptoms that are new or that occur suddenly may be evaluated by an emergency medicine specialist .

    Ongoing (chronic) eye problems that may be worsening are usually evaluated by an eye doctor ( ophthalmologist ). A gradual change in your vision or chronic eye problems may include:

    • Vision changes. These may include:
      • Trouble adjusting your vision when entering a dark room.
      • Trouble focusing on close or faraway objects.
      • Dark spots in the center of your vision field.
      • Lines or edges that appear wavy.
    • Eyelid problems, such as a stye or chalazion (a small, hard lump).
    • Discharge or irritation of the eyeball or eyelids, such as an infection of the inner edge of the lower eyelid ( dacryocystitis ) or pinkeye ( conjunctivitis ).
    • Sensitivity to light ( photophobia ).
    • Inability to see well at night (night blindness). A decrease in night vision may be caused by nearsightedness, cataracts, macular degeneration, or conditions that affect the retina .

    People often tolerate minor eye irritation and problems for a long time, until the irritation or problems become bothersome enough to seek care. People who have skin problems and allergies often have ongoing minor problems with the skin of their eyelids and allergic irritation of the eyes.

    As you reach your 40s and 50s, it is common to have some vision changes and possibly to need glasses. Some of the changes may also cause other symptoms, like headaches and nausea, that affect your ability to function.

    Some children may have special risks for eye problems. Vision screening is recommended for infants who were either born at or before 30 weeks, whose birth weight was below 3.3 lb (1500 g), or who have serious medical conditions. Most vision problems are noticed first by the parents. See tips for spotting eye problems in your child. The first screening is recommended about 4 to 7 weeks after birth. 1

    Check your symptoms to decide if and when you should see a doctor.

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    Eye Problems: Using Eyedrops and Eye Ointment

    Check Your Symptoms

    Are you having eye or vision problems?
    Yes
    Eye or vision problems
    No
    Eye or vision problems
    How old are you?
    Less than 4 years
    Less than 4 years
    4 years or older
    4 years or older
    Are you male or female?
    Male
    Male
    Female
    Female
    Have you had an eye injury within the past week?
    Yes
    Eye injury within past week
    No
    Eye injury within past week
    Could you be having symptoms of a stroke?
    Yes
    Symptoms of stroke
    No
    Symptoms of stroke
    Have you had any new vision changes?
    These could include vision loss, double vision, or new trouble seeing clearly.
    Yes
    New vision changes
    No
    New vision changes
    Did you have a sudden loss of vision?
    A loss of vision means that you cannot see out of the eye or out of some part of the eye. The vision in that area is gone.
    Yes
    Sudden vision loss
    No
    Sudden vision loss
    Do you still have vision loss?
    Yes
    Vision loss still present
    No
    Vision loss still present
    Did the vision loss occur within the past day?
    Yes
    Vision loss occurred in the past day
    No
    Vision loss occurred in the past day
    Are you having trouble seeing?
    This means you are having new problems reading ordinary print or seeing things at a distance.
    Yes
    Decreased vision
    No
    Decreased vision
    Have you had double vision?
    Yes
    Double vision
    No
    Double vision
    Are you seeing double now?
    Yes
    Double vision now present
    No
    Double vision now present
    Did the double vision occur within the past day?
    Yes
    Double vision occurred in the past day
    No
    Double vision occurred in the past day
    Do you have any eye pain?
    Yes
    Eye pain
    No
    Eye pain
    How bad is the pain on a scale of 0 to 10, if 0 is no pain and 10 is the worst pain you can imagine?
    8 to 10: Severe pain
    Severe eye pain
    5 to 7: Moderate pain
    Moderate eye pain
    1 to 4: Mild pain
    Mild eye pain
    Do you have symptoms of a serious illness?
    Yes
    Symptoms of serious illness
    No
    Symptoms of serious illness
    Does light make your eyes hurt?
    Yes
    Sensitivity to light
    No
    Sensitivity to light
    Does the light hurt so much that you have trouble opening your eyes?
    Yes
    Hard to open eyes because of discomfort with light
    No
    Hard to open eyes because of discomfort with light
    Have you noticed new floaters or an increasing number of floaters?
    Floaters look like dark specks, strings, or cobwebs that float through the eye.
    Yes
    New or increasing floaters
    No
    New or increasing floaters
    Was there a sudden shower of floaters?
    Yes
    Sudden shower of floaters
    No
    Sudden shower of floaters
    Have you noticed flashes of light that are new or different from any you have had before?
    Yes
    Flashes of light
    No
    Flashes of light
    Did the flashes of light start suddenly?
    Yes
    Sudden flashes of light
    No
    Sudden flashes of light
    Does it feel like there is something in the eye?
    This is worse than the eye feeling gritty or a little irritated. This actually may make it hard to keep the eye open.
    Yes
    Feels like something is in eye
    No
    Feels like something is in eye
    Is it very hard or impossible to open the eye because of the discomfort?
    Yes
    Hard to open eye because of discomfort with feeling something in eye
    No
    Hard to open eye because of discomfort with feeling something in eye
    Is there any redness in the part of the eye that's usually white?
    This does not include a blood spot on the eye.
    Yes
    Redness in part of eye that's usually white
    No
    Redness in part of eye that's usually white
    Has the eye been red for more than 24 hours?
    Yes
    Eye red for more than 24 hours
    No
    Eye red for more than 24 hours
    Do you think the eyelid or the skin around the eye may be infected?
    Symptoms could include redness, pus, increasing pain, or a lot of swelling. (A small bump or pimple on the eyelid, called a stye, usually is not a problem.) You might also have a fever.
    Yes
    Symptoms of infection around eye
    No
    Symptoms of infection around eye
    Do you think you may have a fever?
    Yes
    Possible fever
    No
    Possible fever
    Do you have diabetes or a weakened immune system?
    What weakens the immune system in an adult or older child may be different than in a young child or baby.
    Yes
    Diabetes or immune problem
    No
    Diabetes or immune problem
    Is there any pus coming from the area around the eye (not from the eye itself)?
    Yes
    Pus from area around eye
    No
    Pus from area around eye
    Is there any blood in the eye?
    This includes blood spots on the surface of the eye.
    Yes
    Blood spot or blood in eye
    No
    Blood spot or blood in eye
    Is there any blood in the colored part of the eye?
    Blood that is only in the white part of the eye is usually not as serious as blood in the colored part of the eye.
    Yes
    Blood is in colored part of eye
    No
    Blood is in colored part of eye
    Does the blood cover more than one-fourth of the white part of the eye?
    Yes
    Blood covers more than one-fourth of white of the eye
    No
    Blood covers more than one-fourth of white of the eye
    Is there any pus or thick drainage coming from the eye (not from the skin around the eye)?
    This does not include water or thin, watery drainage. Pus is thicker and may make the eyelids stick together.
    Yes
    Pus draining from eye
    No
    Pus draining from eye
    Have you had this type of drainage for more than 24 hours?
    Yes
    Drainage for more than 24 hours
    No
    Drainage for more than 24 hours
    Does the white of the eye look yellow?
    Yes
    White of eye looks yellow
    No
    White of eye looks yellow
    Do you think that a medicine could be causing your eye problem?
    Think about whether the problem started soon after you began using a new medicine or a higher dose of a medicine.
    Yes
    Medicine may be causing eye problem
    No
    Medicine may be causing eye problem
    Do you have an eyelid problem?
    This could be swelling, itching, or a bump in the eyelid.
    Yes
    Eyelid problem
    No
    Eyelid problem
    Has the eyelid problem lasted for more than 2 days?
    Yes
    Eyelid problem for more than 2 days
    No
    Eyelid problem for more than 2 days
    Are you having a contact lens problem?
    Yes
    Contact lens problem
    No
    Contact lens problem
    Can you remove the contact lenses?
    Yes
    Able to remove contact lenses
    No
    Unable to remove contact lenses
    Does removing the contact lenses make the eye problem better?
    Yes
    Removing contact lenses helps
    No
    Removing contact lenses helps
    Has the size or shape of the pupil changed? (The pupil is the black center of the eye.)
    Yes
    Pupil changes
    No
    Pupil changes
    Did the pupil changes occur during the past 2 days (48 hours)?
    Yes
    Pupil changes occurred during past 48 hours
    No
    Pupil changes occurred during past 48 hours
    Are the eyes moving normally?
    Examples of abnormal movement include the eyes not moving together or not looking in the same direction.
    Yes
    Eyes moving normally
    No
    Eyes not moving normally
    Is the problem with the eyes' movement a new problem that you have not noticed before?
    Yes
    Change in eye movement is new
    No
    Change in eye movement is new
    Have you had eye problems for more than 2 weeks?
    Yes
    Eye problems for more than 2 weeks
    No
    Eye problems for more than 2 weeks
    Eye Injuries

    Many things can affect how your body responds to a symptom and what kind of care you may need. These include:

    • Your age. Babies and older adults tend to get sicker quicker.
    • Your overall health. If you have a condition such as diabetes, HIV, cancer, or heart disease, you may need to pay closer attention to certain symptoms and seek care sooner.
    • Medicines you take. Certain medicines, herbal remedies, and supplements can cause symptoms or make them worse.
    • Recent health events, such as surgery or injury. These kinds of events can cause symptoms afterwards or make them more serious.
    • Your health habits and lifestyle, such as eating and exercise habits, smoking, alcohol or drug use, sexual history, and travel.

    Certain health conditions and medicines weaken the immune system's ability to fight off infection and illness. Some examples in adults are:

    • Diseases such as diabetes, cancer, heart disease, and HIV/AIDS.
    • Long-term alcohol and drug problems.
    • Steroid medicines, which may be used to treat a variety of conditions.
    • Chemotherapy and radiation therapy for cancer.
    • Other medicines used to treat autoimmune disease.
    • Medicines taken after organ transplant.
    • Not having a spleen.

    Make an Appointment

    Based on your answers, the problem may not improve without medical care.

    • Make an appointment to see your doctor in the next 1 to 2 weeks.
    • If appropriate, try home treatment while you are waiting for the appointment.
    • If symptoms get worse or you have any concerns, call your doctor. You may need care sooner.

    Seek Care Now

    Based on your answers, you may need care right away. The problem is likely to get worse without medical care.

    • Call your doctor now to discuss the symptoms and arrange for care.
    • If you cannot reach your doctor or you don't have one, seek care in the next hour.
    • You do not need to call an ambulance unless:
      • You cannot travel safely either by driving yourself or by having someone else drive you.
      • You are in an area where heavy traffic or other problems may slow you down.

    Pain in adults and older children

    • Severe pain (8 to 10): The pain is so bad that you can't stand it for more than a few hours, can't sleep, and can't do anything else except focus on the pain.
    • Moderate pain (5 to 7): The pain is bad enough to disrupt your normal activities and your sleep, but you can tolerate it for hours or days. Moderate can also mean pain that comes and goes even if it's severe when it's there.
    • Mild pain (1 to 4): You notice the pain, but it is not bad enough to disrupt your sleep or activities.

    Try Home Treatment

    You have answered all the questions. Based on your answers, you may be able to take care of this problem at home.

    • Try home treatment to relieve the symptoms.
    • Call your doctor if symptoms get worse or you have any concerns (for example, if symptoms are not getting better as you would expect). You may need care sooner.

    Pain in children under 3 years

    It can be hard to tell how much pain a baby or toddler is in.

    • Severe pain (8 to 10): The pain is so bad that the baby cannot sleep, cannot get comfortable, and cries constantly no matter what you do. The baby may kick, make fists, or grimace.
    • Moderate pain (5 to 7): The baby is very fussy, clings to you a lot, and may have trouble sleeping but responds when you try to comfort him or her.
    • Mild pain (1 to 4): The baby is a little fussy and clings to you a little but responds when you try to comfort him or her.

    Symptoms of serious illness in a baby may include the following:

    • The baby is limp and floppy like a rag doll.
    • The baby doesn't respond at all to being held, touched, or talked to.
    • The baby is hard to wake up.

    Certain health conditions and medicines weaken the immune system's ability to fight off infection and illness. Some examples in children are:

    • Diseases such as diabetes, cystic fibrosis, sickle cell disease, and congenital heart disease.
    • Steroid medicines, which are used to treat a variety of conditions.
    • Medicines taken after organ transplant.
    • Chemotherapy and radiation therapy for cancer.
    • Not having a spleen.

    Symptoms of a stroke may include:

    • Sudden numbness, tingling, weakness, or paralysis in your face, arm, or leg, especially on only one side of your body.
    • Sudden vision changes.
    • Sudden trouble speaking.
    • Sudden confusion or trouble understanding simple statements.
    • Sudden problems with walking or balance.
    • A sudden, severe headache that is different from past headaches.

    Seek Care Today

    Based on your answers, you may need care soon. The problem probably will not get better without medical care.

    • Call your doctor today to discuss the symptoms and arrange for care.
    • If you cannot reach your doctor or you don't have one, seek care today.
    • If it is evening, watch the symptoms and seek care in the morning.
    • If the symptoms get worse, seek care sooner.

    Many prescription and nonprescription medicines can cause eye problems or changes in vision. A few examples are:

    • Antihistamines.
    • Some antidepressants (tricyclic antidepressants).
    • Erection medicines.
    • Medicines for bladder control problems (anticholinergics).
    • Medicines that affect blood clotting, such as aspirin, warfarin (such as Coumadin), heparin, and clopidogrel (Plavix).
    • Any kind of medicine that you put in your eye.

    Call 911 Now

    Based on your answers, you need emergency care.

    Call 911 or other emergency services now.

    Symptoms of serious illness may include:

    • A severe headache.
    • A stiff neck.
    • Mental changes, such as feeling confused or much less alert.
    • Extreme fatigue (to the point where it's hard for you to function).
    • Shaking chills.

    Home Treatment

    Home treatment measures may give you some relief from your eye symptoms.

    • Rest your eye.
    • Don't rub your eye.
    • If you wear contacts, take the contacts out to rest the eyes.
    • Use cold or warm compresses, whichever feels best.
    • Gently flush your eye with cool water.
    • Avoid bright lights or use dark glasses to protect the eye.
    • Nonprescription eyedrops, such as artificial tear solutions, such as Hypo Tears, may be used to moisten your eyes.

    To learn how to use eyedrops and eye ointment, see:

    Click here to view an Actionset. Eye Problems: Using Eyedrops and Eye Ointment.

    For treatment information for these common eye problems, see the topics:

    Pinkeye.
    Objects in the Eye.
    Styes and Chalazia.

    Symptoms to watch for during home treatment

    Call your doctor if any of the following occur during home treatment:

    • Vision changes occur, such as blurred vision, loss of vision, or double vision.
    • Pain or drainage does not get better.
    • Increased sensitivity to light ( photophobia ) develops.
    • You have blood in the eye.
    • Swelling or redness develops around the eye area (periorbital cellulitis).
    • Signs of infection are present.
    • Symptoms become more severe or frequent.

    If you wear contacts, be sure to remove your contacts when your eye problem starts.

    Prevention

    Take good care of your eyes to prevent eye problems.

    • Injuries from ultraviolet (UV) light can be prevented by wearing sunglasses that block UV rays and by wearing broad-brimmed hats. Be aware that the eye can be injured from sun glare during boating, sunbathing, or skiing. Use eye protection while you are under tanning lamps or using tanning booths.
    • Wear goggles or protective glasses when you are handling chemicals, operating power tools, hammering nails, or playing sports that involve a risk of a blow to the eye, such as racquetball or hockey.
    • Wear goggles or protective glasses at all times if you have only one functional eye.
    • Be a good example to your children by wearing goggles or protective glasses when needed at work or play.
    • Get periodic vision checkups.
    • If you wear contact lenses, take good care of them. See caring for contact lenses.
    • Keep your blood pressure under control. High blood pressure can damage the blood vessels that supply blood to the eye.

    People who have diabetes are at risk for a vision problem called diabetic retinopathy , which is a complication of having high blood sugar over a long time. People who have diabetes need regular eye exams so that the early stages of diabetic retinopathy can be detected and in some cases treated. They also need to keep their blood sugar levels as close to normal as possible to prevent blood vessel damage from long-term high blood sugar.

    It is important to protect your children's vision. Regular eye exams identify problems early, and corrective measures can be taken. Watching a lot of television, playing video games, or frequent computer use can decrease your child's natural blink reflex, which can cause dry, red, and irritated eyes. Do not let your child use laser pointers or laser toys. These can cause permanent eye damage if the laser is pointed at the eye.

    Most vision problems are noticed first by the parents. See tips for spotting eye problems in your child.

    For tips on how to prevent eye infections, see the topic Pinkeye.

    For tips on how to prevent eye injuries, see the topic Eye Injuries.

    Preparing For Your Appointment

    To prepare for your appointment, see the topic Making the Most of Your Appointment.

    You can help your doctor diagnose and treat your condition by being prepared to answer the following questions:

    • What are your main symptoms? How long have you had your symptoms?
    • Do your symptoms affect one or both eyes?
    • Have you had this problem in the past? If so, do you know what caused the problem at that time? How was it treated?
    • Do you wear contact lenses or eyeglasses? Do you think the problem is because of your contacts?
    • Have you had any vision changes, pain in the eye, double vision, excessive tearing, or increased sensitivity to light?
    • Have you had any exposure to toxic fumes, chemicals, or smoke?
    • Does anyone in your family or at your workplace have an eye infection, such as drainage from the eye or red and swollen eyelids?
    • Do you have allergies, or are your eye symptoms occurring at certain times of the year?
    • What home treatment measures have you tried? Did they help?
    • What prescription or nonprescription medicines have you used? Did they help?
    • Have you recently traveled outside the country?
    • Do you smoke?
    • Do you have any health risks?

    References

    Citations

    1. American Academy of Pediatrics Section on Ophthalmology, et al. (2006). Screening examination of premature infants for retinopathy of prematurity. Pediatrics, 117(2): 572?576. [Errata in Pediatrics, 117(4): 1468 and Pediatrics, 118(3): 1324.]

    Credits

    By Healthwise Staff
    William H. Blahd, Jr., MD, FACEP - Emergency Medicine
    Kathleen Romito, MD - Family Medicine
    Last Revised November 6, 2013

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