Bloodshot Eyes Causes and Treatments

Why are my eyes red and should I be concerned?

The term "red eye" is used to describe eyes that are red and bloodshot. Bloodshot eyes are usually painless. They develop when blood vessels near the surface of the eye become swollen.

You can develop bloodshot eyes temporarily after drinking alcohol, staring at a computer screen too long, or forgetting to change your contact lenses. But bloodshot eyes can be caused by something more serious as well, such as an eye injury or infection.

This article will discuss the most common causes of bloodshot eyes and what you can do about each one. Of course, it is always best to seek the advice of your eye healthcare provider, but there are a few red eye home remedies you can try in the meantime for relief.

causes of red and bloodshot eyes

Verywell / Brianna Gilmartin

1

Contact Lens Wear

Contact lenses can be irritating to the eyes, causing them to turn red. Some common reasons contacts may irritate your eyes include:

  • Poor fit
  • Leaving them in too long
  • Traumatic removal
  • Wearing a damaged contact lens
  • Poor hygiene

Sometimes contact lens complications can result in a bacterial infection. These infections occur on the cornea of the eye, and they can threaten vision.

What To Do

If you have bloodshot eyes associated with contact lens wear, see an eye doctor right away. They will check for possible complications and provide the correct treatment.

2

Frequent Use of Eye Drops

Do you reach for eye drops when you wake up with bloodshot eyes? Surprisingly, frequent use of "get the red out" eye drops can actually cause “rebound dilation” of the blood vessels in the eyes, which can actually make the eyes appear even redder.

What To Do

Before using eye drops of any kind, it's a good idea to first consult with your eye doctor. They can help you identify the cause of your bloodshot eyes and prescribe an effective treatment.

3

Computer Vision Syndrome

Red, dry eyes result from a lack of moisture to the eyes. Your tears work to replenish moisture to the eyes by blinking.

Blinking is one of the fastest reflexes of the body. However, people tend to blink about half as much as normal when working on a computer.

What To Do

Try to reduce redness by blinking more often. You can also replenish moisture in the eye by using artificial tears.

4

Lack of Sleep

If you don't get enough sleep, your eyes may show it. Losing sleep tends to increase blood and fluid around the eyes. This makes them appear puffy and red. Lack of sleep can also lead to dry eyes.

Your eyes need fluid to clean and renew. Unfortunately, when you don't get enough sleep, your eyes don't get the long rest they need for proper fluid circulation.

What To Do

Be sure to get a good night's sleep for overall eye health.

5

Swimming

Many people develop bloodshot eyes after spending some time in a pool. Redness occurs when chlorine used in pools causes the eyes to become irritated. As with other causes of bloodshot eyes, this leads blood vessels near the surface of the eye become enlarged and dilated.

What To Do

If you're prone to getting bloodshot eyes from swimming, wearing swim goggles in the pool is a good option.

6

Smoking Cigarettes

Smoking a cigarette releases several harmful chemicals that can irritate the sensitive tissues of the eyes. For example, exposure to formaldehyde, ammonia, and hydrogen sulfide can lead to eye inflammation and bloodshot eyes.

Smoking can also increase the risk of cataracts, cloudiness in the lens of the eye.

7

Alcohol and Cannabis

Drinking alcohol can cause some people to develop eye redness. This is because alcohol can cause vasodilation, which is when your blood vessels widen.

Vasodilation can cause the vessels on the white part of the eye to become larger and more visible. Also, alcohol is dehydrating and can cause the eyes to appear red and tired.

It's well known that using cannabis causes bloodshot eyes too, whether you smoke the plant or consume it as an edible.

The redness occurs because compounds in the cannabis plant, known as cannabinoids, cause vasodilation when they bind to cannabinoid receptors in your retinas.

What To Do

The only way to avoid bloodshot eyes due to alcohol or cannabis is to avoid using alcohol or cannabis. Using OTC eyedrops may temporarily relieve redness, but the redness will likely reappear when you use alcohol or cannabis again.

8

Allergies

You can have bloodshot eyes due to allergies. In addition, red eyes from allergies often burn and itch.

With allergies, the eyes become red because the blood vessels in the front part of the eye dilate and become larger. As a result, fluid accumulates and causes swelling.

What To Do

You can treat this type of redness with cold compresses, artificial tears, avoidance of triggers, and OTC allergy medications.

Treatment can also include eye drops targeted for allergies. (Note that systemic allergy medications can dry out the eyes and thereby worsen symptoms.)

9

Pregnancy

Pregnancy causes big changes to several hormones in the body. These changes can cause the body to produce fewer tears, so your eyes may feel irritated or gritty. In addition, they may appear red and sensitive to light.

What To Do

If you find it challenging to wear contacts during pregnancy, you may opt for glasses until after you give birth.

10

Photokeratitis

Photokeratitis is a painful condition that occurs when your eyes are exposed to ultraviolet (UV) rays. You can think of photokeratitis as a sunburn that affects the corneas of your eyes.

Ultraviolet rays naturally come from the sun and are also artificially produced in tanning beds. You can get photokeratitis by spending time in the sun or in a tanning bed without sun protection. It can also happen when UV rays reflect off of snow or ice and into your eyes.

In addition to redness, symptoms of photokeratitis include watery eyes, blurry vision, and light sensitivity. Symptoms typically resolve within six to 48 hours, though they may be more severe if you are exposed to UV rays for a prolonged period of time.

What To Do

Go someplace dark, ideally indoors. Remove contact lenses if you wear them and avoid touching your eyes. You can use artificial tears or take an OTC pain reliever like ibuprofen to ease your symptoms, but if they don't improve within 48 hours, see your healthcare provider.

11

Pink Eye

Bloodshot eyes can be caused by pink eye, also known as conjunctivitis. Pink eye is a swelling or infection of the clear, protective layer that covers the front part of the eye.

Pink eye can be caused by allergies, bacteria, viruses, or toxic substances. It is common but usually not serious.

What To Do

Visit your healthcare provider if you suspect your bloodshot eyes are due to pink eye. This is especially important if it is associated with pain and vision changes.

12

Blepharitis

Blepharitis is a common reason for painful, bloodshot eyes. It is caused by impacted oil glands that can't release the oily layer of the tear film well. This leads to inflammation of the eyelid.

Common causes include:

  • Poor makeup hygiene
  • Decreased blinking
  • Ocular demodicosis (a skin mite that normally lives on human skin)

Blepharitis is not infectious and usually does not cause permanent damage to your eyesight. If you have blepharitis, you may notice:

  • A sandy or burning sensation in your eyes
  • Excessive tearing
  • Itching
  • Red and swollen eyelids
  • Dry eyes
  • Crusting eyelids

What To Do

Good eyelid hygiene is important. For example, if you have blepharitis, your healthcare provider may instruct you to clean your lids and lashes with eyelid scrubs regularly. If that doesn't help, your healthcare provider may prescribe antibiotics or other medications.

13

Uveitis

Uveitis is an inflammation of the eye's uvea, the middle layer of the eyeball. Symptoms of this condition can occur suddenly and get worse very quickly. It can cause:

  • Redness
  • Pain
  • Blurry vision
  • Floaters
  • Light sensitivity

Your healthcare provider will most likely prescribe a form of steroids to help reduce swelling. If they can determine the underlying cause for the uveitis, they will treat the cause as well.

What To Do

Uveitis should be treated quickly. Other complications, such as uveitic glaucoma or retinal and choroidal scarring, may occur if it lingers.

14

COVID and Red Eyes

Studies show that eye symptoms occur in about 5% of COVID-19 cases. When eye symptoms do occur, they often appear before other systemic symptoms, such as fever and headaches.

The most common eye symptoms associated with COVID-19 include bloodshot eyes, sensitivity to light (photophobia), soreness, and itchiness. Eye symptoms typically resolve around the same time that other symptoms do.

What To Do

You can use over-the-counter artificial tears to soothe redness and irritation. If your symptoms persist, or if your vision is affected in any way, you should contact your healthcare provider.

15

Dry Eye Syndrome

A common cause of bloodshot eyes is dry eye syndrome. It occurs when there are not enough natural tears to keep the front part of the eye moist.

When your eye becomes dry, it also becomes red and irritated. Dry eyes can occur from:

  • Staring at a computer screen for an extended amount of time
  • Lack of quality sleep
  • Wearing your contact lenses for too long
  • Certain medications
  • Hormonal changes 
  • Plugged tear glands

What To Do

If you have bloodshot eyes due to dry eye syndrome, it might be helpful to use eye drops that moisten the eyes. Lubricant, or rewetting, eye drops are sold over the counter and can be used throughout the day.

16

Injury

Redness sometimes occurs with an eye injury. Injuring your eye could be as simple as sticking yourself with a mascara wand or accidentally scratching your eye with a sharp fingernail.

When you injure your eye, blood vessels inside the eye enlarge and dilate. This brings blood and cells to heal and repair the injury. A red eye from an injury is also a warning sign to tell you something is wrong with your eye.

What To Do

Visit your healthcare provider to make sure that you did not significantly damage your eye.

17

Corneal Ulcer

A corneal ulcer occurs when the eye's cornea becomes infected, leading to a sore on the cornea. When this happens, nearby blood vessels become enlarged and swollen. As cells rush in to help fight the infection, it can cause visible redness.

With a corneal ulcer, the nearby blood vessels enlarge to quickly get important inflammatory cells to the site. In addition to bloodshot eyes, symptoms of a corneal ulcer include:

  • Pain
  • Discharge
  • White spot on the cornea
  • Blurred vision
  • Itching
  • Sensitivity to light

The cornea is avascular, meaning normally, the cornea does not have any blood vessels in it. Instead, it gets most of its oxygen and nutrients from tears and the air.

Medicated drops that are targeted to treat the cause of the underlying infection are often used to treat corneal ulcerations. The drops may be antibacterial, antiviral, or antifungal.

Steroids are not commonly started at the beginning of corneal ulcer treatment. But your healthcare provider may prescribe them to reduce scarring and inflammation once the infection is under control.

What To Do

Seek treatment right away. Corneal ulcer treatment needs to be aggressive to prevent potential vision loss and blindness.

18

Subconjunctival Hemorrhage

A subconjunctival hemorrhage (also known as bleeding in the eye) causes the white part of the eye to become completely red. It occurs when one of the blood vessels bursts underneath the conjunctiva, the transparent, clear tissue that covers the white part of the eye.

The blood has no place to go, so it spreads out like ketchup under plastic wrap. Sometimes the blood can gather so much that the eye appears swollen and pouches outward.

A bleeding eye can look very scary, but it usually does not cause permanent harm to the eye. Common causes include:

  • Straining too hard
  • Lifting something too heavy
  • Sneezing or coughing too hard

What To Do

Schedule an appointment with your eye doctor. They will examine your eye and make sure that no other damage is present. They may also measure your eye pressure and look inside your eye.

19

Acute Angle-Closure Glaucoma

Sometimes a bloodshot eye can signal a serious condition. For example, one severe eye condition that may cause red eye is acute angle-closure glaucoma.

It occurs when the fluid pressure inside the eye rises quickly. This serious type of glaucoma usually causes:

  • Sudden redness in the eye
  • Severe eye pain
  • Blurred vision (usually occurring in only one eye)

What To Do

Acute angle-closure glaucoma is a serious medical emergency that must be treated immediately. Make sure to visit your eye doctor right away.

20

Episcleritis

Another cause of bloodshot eyes is episcleritis. This is an inflammation of the thin, clear layer of tissue that lies between the conjunctiva and sclera.

Episcleritis causes mild eye pain, irritation, and eye redness. Sometimes the eyes become tender to the touch.

Scleritis is a deeper inflammation of the outer coat of the eyeball, called the sclera. In this condition, the eye is usually deep red.

Often, scleritis is caused by an autoimmune condition. Therefore, your healthcare provider may order blood work as part of diagnosing your condition.

What To Do

Episcleritis can be treated with artificial tears. In addition, steroids can be used if this condition is causing troublesome symptoms.

Scleritis needs immediate medical attention. It often requires oral anti-inflammatories and topical steroid drops.

When To Be Concerned About Bloodshot Eyes

Bloodshot eyes are most commonly due to harmless causes that will resolve on their own, even without treatment. This includes the following:

  • Wearing contact lenses
  • Using eye drops too frequently
  • Staring at a computer screen for long hours
  • Not getting enough sleep
  • Swimming
  • Smoking cigarettes
  • Using alcohol or cannabis
  • Being pregnant
  • Photokeratitis

Allergies, pink eye, blepharitis, and dry eye syndrome are also common causes of bloodshot eyes. While they are not cause for concern, you may need OTC or prescription medication to ease your symptoms. COVID can cause you to have red eyes, too, but the symptom should resolve as you recover from COVID.

If you think you may have one of the following conditions, you should get medical attention as soon as possible to prevent serious complications:

  • Uveitis
  • Eye injury
  • Corneal ulcer
  • Subconjunctival hemorrhage
  • Acute angle-closure glaucoma
  • Episcleritis

Seek immediate medical attention if you experience vision changes, floaters in your eyes, light flashes, a foreign body sensation in your eye, signs of infection, or any other eye symptoms that concern you.

Summary

Bloodshot eyes can result from many things. Most often, the things that cause dry, red, irritated eyes are minor and can be treated at home.

However, other causes of red eyes can be more serious and threaten your vision and overall health. So, it's always best to consult your healthcare provider for an accurate diagnosis.

Frequently Asked Questions

  • Why are my eyes red when I wake up?

    Someone may wake up with red, bloodshot eyes if they have dry eye syndrome or blepharitis. Eyes do not produce tears when someone is sleeping, so someone with either of these conditions could wake up with dry, red eyes due to a lack of lubricating tears.

  • How can I quickly resolve bloodshot eyes?

    Over-the-counter artificial tears can help resolve redness in many cases. Taking an antihistamine for seasonal allergies, placing a cool compress over closed eyes, avoiding irritants such as cigarette smoke, using a dehumidifier, and practicing good hygiene with frequent hand washing and clean linens are all practices that help relieve red eyes.

  • When should someone consult a physician about bloodshot eyes?

    It's best to seek medical attention if eye redness or bloodshot eyes are accompanied by certain symptoms, including:

    • Yellow, brown, or green crust in the eyes
    • Pain or tenderness
    • Light sensitivity
    • Fever
    • Symptoms lasting more than one week
    • Exposure to pink eye
  • Do red eyes go away on their own?

    Red eyes due to swimming, drinking alcohol, wearing contact lenses, or another transient cause will go away on their own. However, red eyes can sometimes be due to serious conditions that require medical attention, such as scleritis, which could be a sign of rheumatoid arthritis or another autoimmune disease.

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By Troy Bedinghaus, OD
Troy L. Bedinghaus, OD, board-certified optometric physician, owns Lakewood Family Eye Care in Florida. He is an active member of the American Optometric Association.