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Dr. Dan B.
Dr. Dan B., Board Certified Ophthalmologist
Category: Eye
Satisfied Customers: 3343
Experience:  Eye surgeon experienced in cataracts, glaucoma, retina & neuro-ophthalmology
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What is the best treatment for bloodshot eyes?

Resolved Question:

What is the best treatment for bloodshot eyes?
Submitted: 5 years ago.
Category: Eye
Expert:  Dr. Dan B. replied 5 years ago.
Doctor DanB : Hello and thanks for your question. Are you using drops that have a redness reliever in them? If so, for how long?
Doctor DanB : I suspect that you have some inflammation in your eyelids which causes this burning, itching, redness, and irritation.  This inflammation is called blepharitis; it is very common, not a severe problem, and can be controlled if some simple daily treatments are applied.  Let me address this in a minute.  First let me say that I think that if you are using eye drops with a redness reliever component in them, unfortunately, these can be part of the problem. These get-the-red-out drops are useful to decrease redness in an eye on a short-term basis; however, when they are used chronically, over many weeks to months, the eyes can get habituated to them, and more and more of the drop is required to keep the eye from being red.  For this reason, I think it is appropriate only to use those kinds of drops for a few days at a time only.  I think blepharitis may be a contributing reason why the eye is red to begin with but the redness reliever drops are also keeping the eye red.  To that end... I would recommend stopping any redness-reliever drops right now.  Even with starting the treatments I'm going to explain to you for blepharitis, if the redness-reliever drop has been used for a long time, it will take awhile for the effects of the drops to "wash out", so to speak.  By awhile I mean that it may take 4-6 weeks for the eyes to stop being so red after having stopped these drops.  Second, In order to treat blepharitis, everyday in the morning you should do two things: 1. hot compresses and 2. eyelid scrubs. You should do hot compresses for 5-10 minutes over each eye at the same time. It should be as hot as you can tolerate without burning your skin, massaging the eyelids while they are on there. Then, use either commercially available preparations or a dilute baby shampoo solution to scrub your eyelashes on all 4 eyelids. The commercially available preparations are called Ocusoft or Sterilid which are both over-the-counter eyelash scrubbing treatments. These cost more money but are quicker to use. Otherwise, the cheaper alternative is the dilute baby shampoo (4-5 drops Johnson's shampoo in 1/4 cup warm water), you will take the wipe (or dip a qtip in the dilute baby shampoo solution) and use that to scrub right on the eyelashes of each eyelid for 15 seconds. That will take 60 seconds when done to all 4 eyelids. The scrubbing is done right on the eyelid margin, where the eyelashes come out. After that, just splash some water on the eyes and you're done. It does take about 3-4 weeks of doing this consistently every day before it really kicks in, so don't stop it thinking it's not working. Also the eyes are still significantly dry during this 3-4 weeks so use the artificial tears you bought 4x/day in both eyes (one drop per application). After 4 weeks you should be able to start tapering off of the tears to as you need them.  Any artificial tear without this redness-reliever chemical in them should be fine; some brand name examples that my patients like using are Refresh, Systane, Blink, Optive.  Just doing the artificial tears, hot compresses and eyelid scrubs alone would likely start to help you after three or 4 weeks--but remember it could take this long of doing it everyday before you see a significant effect, so don't stop it thinking it's not working. There are many reasons for dry eye besides blepharitis that one person can have at the same time. If you are a person that doesn't make their own tears very well, then you may also benefit from a prescription drop called Restasis, which actually modulates a person's immune system to help them make more of their own tears. This drop actually requires constant usage on a daily basis for up to 10-12 weeks before its effect kicks in (takes awhile to change the immune response in the body).  You may also need an antibiotic/steroid combination drop if the inflammation has not significantly calmed down after 2-3 weeks.
Doctor DanB : Does this information help address your concerns? Does this make sense? Do you have any other concerns about this that we haven't addressed? It appears you are momentarily out of the chat room.  I am happy to be able to help you today. I will also be happy to answer any other questions until you have the information you need; please just respond with any further needs and I will address them then.If not, Please help me get credit for my efforts in answering your questions and press the ACCEPT button for this encounter; this allows part of the funds that you have deposited to the website to be released for my efforts to assist you. This does not end our conversation, however-we can continue to discuss any of your concerns without further charges until you are satisfied.Any positive feedback and/or bonus you may feel prompted to provide would be welcomed and is appreciated. Thanks for your inquiry!My opinion is solely informative and does not constitute a formal medical opinion or recommendation. For a formal medical opinion and/or recommendation you must see an eye doctor.

The detailed explanation for the eyelid scrub is mostly clear for the baby shampoo. I will try to get the Ocusoft or Sterilid. Do therey have specific instructructions for their use. Could you provide more specific information on their use? Thanks


By the way, I no longer have any irritation or burning. My eyesight is as good as it always was (I still use the same lens prescription) and have not problems with my sight. Just the redness... I already used Restasos before, and it turns out the problem is not one of dryness. I do appear to produce my own tears perfectly well. So my doctor asked me to stop. But they seem to have run out of prescriptions for the redness. So do I still need the articifial tear products? Or do I just do the hot compresses to see how it works out? Also heard of the I-BRITE surgery to remove redness. Is it safe and/or recommended?

Doctor DanB :

The only difference with using the baby shampoo or the Ocusoft/Sterilid is that you would use one of those as a means of scrubbing the eyelashes for 15 seconds, each eyelid. The Ocusoft is a pad or wipe to scrub the eyelashes with and the Sterilid is a foam you could put on a q-tip instead of dipping a q-tip in dilute baby shampoo. I would still recommend using plain artificial tears (without redness reliever) while you do the hot compresses and eyelash scurbbing for at least a month. As far as the I-BRITE surgery, I wouldn't go near that for this type of problem, because it is risky and would not make your eyes white forever--eventually they would get red again if the underlying cause isn't reversed.


Thanks for your help. Do you have a way of following up to know if this has worked?

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