‘Sore eyes’ is a collective term commonly used to describe conditions that affect the eyes. These conditions typically involve pain, irritation, inflammation or tiredness. The two most common eye problems that lead to sore eyes are conjunctivitis and dry eye syndrome.
Conjunctivitis
This is the inflammation of the clear covering of the eyeball’s forepart. There are several types of conjunctivitis:
Allergic conjunctivitis (AC) - This is mainly caused by pollen, dust, animal dander, or smoke. AC normally presents itself as red watery eyes accompanied by eye itching.
The first step of AC treatment is to remove the offending substance. Artificial tears or eye lubricants can be used to relieve irritation, while an eye decongestant can be used to relieve the redness.
Eye drops containing phenylephrine are easily found in most pharmacies, while others containing naphazoline or tetrahydrozoline can only be obtained from pharmacists. Eye drops with the addition of anti-histamines (e.g. pheniramine maleate or antazoline) or a mast-cell stabiliser (e.g. sodium cromoglycate) could be used to relieve itching.
Viral conjunctivitis (VC) - This is the most common form of infectious conjunctivitis, and it usually appears after a recent cold, sore throat, or contact with someone who is infected. The eye appears pink, with watery discharge similar to that of AC. Sometimes a foreign object sensation in the eye can also be felt.
VC usually heals on its own within one to three weeks, so treatment goals are mainly symptomatic relief. VC can be managed in the same way as AC.
Bacterial conjunctivitis (BC) - Red eyes and the production of thick, sticky pus which cause the eyelids to be ‘glued’ together in the morning are the first signs of BC. A visit to a physician is usually warranted to get antibiotic eye drops for treatment. The use of an eye decongestant is not recommended in BC as it may mask the symptoms of the infection.
Both bacterial and viral conjunctivitis are highly contagious and they spread by hand-to-eye contact. One should wash his hands thoroughly and refrain from touching the non-infected eye after touching his eyes’ or nasal secretions. He should also avoid sharing towels or pillows and swimming in pools. Small children with conjunctivitis should be kept home to avoid spreading it in school. Cool compress can be applied to the eyes to relieve the local burning sensation and itching.
Fungal conjunctivitis - This is a rare but serious condition that should only be managed by a physician.
Dry eye syndrome
Dry eyes can be associated with ageing (especially in menopausal women), some disease states (e.g. Sjogren Syndrome), medication (e.g. anti-histamines and anti-depressants), or a combination of these factors. It can be worsened by environmental conditions such as a dry, dusty or windy environment, or air conditioning or heating systems that increase the evaporation of the tear film.
Staring at the television or computer for long hours without sufficient blinking may lead to insufficient tear production and dry eyes. Long-term contact lens wearers may also suffer from dry eyes.
People with dry eyes may experience a rough and gritty feeling, or the sensation of a foreign object in the eye. Redness of the eye depends on the severity of the dry eyes.
Treating dry eyes
In most cases, correcting the underlying cause is the first line of treatment for dry eyes. The use of eye lubricants to alleviate the dry, scratchy feeling is the next step. Eye lubricants can come in the form of artificial tears and these usually only differ slightly in formulation, pH levels, preservatives and buffering agent.
Some eye lubricants come in a thick gel or ointment form. This type of lubricant is usually made of petrolatum and mineral oil. They are suitable for severe dry eyes as the mixture melts at body temperature to retain water in the eyes for a longer time. These are normally applied at night as it may cause blurring of vision if used in the day.
Do check with your healthcare professional should you have any doubts on managing your sore eyes.