Q: I have worn soft contact lenses on and off for 15 years, and I chronically have red, bloodshot eyes. I've gone for periods of weeks and months wearing only my glasses and avoiding contacts, but honestly my eyes seem less bloodshot when I wear my contacts.
What can I do to clear up my eyes so they are not bloodshot? And does the fact they are chronically bloodshot indicate any eye health problems or disease? — M.A., Georgia
A: The known causes of red eyes take up volumes in the ophthalmic literature. It sounds like you need to obtain a diagnosis for your condition so that the appropriate treatment can be prescribed.
Allergies and dry eye syndrome are probably the two most common causes of red eyes. Wearing contact lenses on top of an already inflamed eye can only lead to further problems. A thorough examination to determine the etiology of your bloodshot eyes is needed. — Dr. Slonim
[Read more about allergies or dry eye syndrome.]
Q: Why do some contact lenses feel more dry than others? Is it better to go with lower water content or higher? — R.D., Georgia
A: This is a very technical question. What are you, an
optometrist looking for some free clinical advice? What the heck... Contact lenses are made from different plastics and silicones that have different characteristics. Some have more water content than others. All contact lenses are subject to evaporation while on the eye — in other words, the environment sucks the water out of the lenses. The rate of this happening depends on many factors: humidity, wind, temperature, your health, what medicines you are taking, how much you blink, the care system you use, how clean the lenses are, etc.
Some eyecare practitioners believe that high water content lenses perform better for those with dry eye, while others believe just the opposite. A few lenses are now available that are made from plastics that resist dehydration and evaporation. They include Proclear Compatibles from CooperVision and Extreme H20 from Benz. The Preference line of lenses from CooperVision also has been touted for dry eye patients.
An in-office procedure is also available that blocks some of the tears from draining away. Tiny plugs are inserted into the tear drainage holes in the eyelids. This is called lacrimal occlusion. It is very safe and very effective for those with clinically dry eyes, and can really help with comfortable contact lens wear. — Dr. Dubow
Q: Why do my eyes water all the time, especially my left eye? — Susie, California
A: This is actually impossible to know without examining you. But you should consider two major things: your tear drainage system may be plugged, or you may have dry eyes. Although this seems contradictory, these two conditions are the most common for causing watery eyes.
If your eyes are constantly watery, with tears dripping onto your face, I would suspect a blockage in your drainage system. This can usually be alleviated by flushing out the tiny tubes that drain the tears.
If your eyes water primarily when you are in wind or cold or when your eyes are irritated, I would suspect dry eyes as the cause. This can be helped by actually blocking the tear drainage system to keep more tears in your eyes.
I recommend you see an eye doctor who is familiar with lacrimology and can test you for these two problems, along with considering other factors such as your lids and how their shapes interact with your eyes. — Dr. Dubow
[Read more about dry eye syndrome.]
Q: I have a tear duct that leaks on regular basis. My doctor recommends surgery. What does this entail? — C.K.
A: Sounds like you need a dacryocystorhinostomy (DCR). This is usually done under local anesthesia as an outpatient through a small incision on the side of the bridge of the nose. It is a type of bypass surgery where the blockage inside the duct is bypassed and a direct re-routing of the tears is done through a man- (or woman-) made opening in the nose.
Typically the procedure has a 94 percent success rate. Rarely some post-op discomfort might occur. Seek out an oculoplastic surgeon with experience in performing this procedure. — Dr. Slonim
[Read more about tear duct leakage and dry eye syndrome.]
Q: Lately I have been experiencing excessive tearing from both eyes, but with no eye allergy symptoms (no red, swollen, or itchy eyes). I am five months pregnant — could excessive tearing be a symptom of pregnancy? What can I do to stop the tears? — E.R., Virginia
A: Excessive tearing can be one of the many symptoms of pregnancy. You can't stop them, just wipe them. There could be a problem with the outflow mechanism (tear ducts) that drains the tears away from the eyes and into the nose. As long as there is no infection or other symptoms that you mentioned, wait until after the delivery to see if the tearing goes away. If you are concerned, check with your eyecare practitioner. — Dr. Slonim
[Read more about tearing and dry eyes.]
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