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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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My eyes are always red! I've been having this problem for a

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My eyes are always red! I've been having this problem for a long time. I went to my eye doctor and he prescribed me steroid drops to help with my dry eyes. However, as soon as I stopped using steroid eye drop, the redness came back to me again! I do not want to use steroid eye drops all the time due to its side affects. any suggestions?
Thank you!
Dr. Dan B. : Hello and thanks for your question. Are you available to chat?

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Dr. Dan B. : How long have you been using Visine? And is it the kind that gets the red out?
Customer: replied 4 years ago.

I don't use Visine now. I'm using FML steriod drops now.

Customer: replied 4 years ago.
Relist: Answer came too late.
For how long did you use Visine? When did you stop for good?
Customer: replied 4 years ago.
I don't remember for how long exactly but i used it for a long time. I stopped using it when I realized that visine actually made my eyes more red at night time. Then, I went to my doctor . He thought I had bacterial infection in my eyes so he prescribed me antibacterial eye drops. The eye drop didn't work for me! Then, I went to an eye doctor he told me that I have dry eyes and the redness is due to allergy. I really don't know what I allergic too tho! He prescribed me prednisolone and this eye drop actually worked really well.. But I had to use it one time a day to keep the redness out tho! Then he prescribed me antihistamine eye drops due to the side affects of steroid drops. Of course the antihistamine eye drop did not work well on me . Then I went to my second eye doctor, he also told me that I have dry eyes, so he wanted me to use artificial tears. He also prescribed me FML eye drop to keep the inflammation down. I realized that whenever I stop using steroid eye drop the red comes back again! I really don't want to use it for the rest if my life. Sorry my story is kinda long ....
First let me say that one of the most common things that causes chronic red eye is when someone uses eye drops with a redness reliever component in them. 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. Therefore, the eye tends to stay red regardless of how much of that drop is used. For this reason, I think it is appropriate only to use those kinds of drops for a few days at a time only.
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. The longer the duration that the drops were used, the longer the duration away from the drops is necessary for the redness to disappear. For some, it can disappear in 4-6 weeks after having stopped these drops. For people who have taken them for years, it can take several months to wash out.
Aside from the use of these redness-reliever drops, the most common reason for chronic red eye is an inflammation of the eyelids called blepharitis. It is so incredibly common and can come in many different varieties, severities, and presentations. It can cause any of the following symptoms: burning, itching, discharge, tearing, dry or gritty feeling, foreign-body sensation, light-sensitivity, redness, pain and/or blurry vision. For some who have blepharitis, they don't have any of these symptoms but can still have the inflammation. Because this is so incredibly common and also because I can't examine you, I would recommend starting the treatment for blepharitis.
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.
Ultimately, though, if you've done all of this and there has been no resolution to the redness, it's possible that there is an ongoing issue that is causing your eyes to still be red. Any foreign-body (something that may have gotten in the eye) or exposure to a chemical that doesn't belong in the eye (cleaners, lotions, medicines, or fumes/vapors) can cause an inflammation in the eye which causes the eye to be bloodshot. Other types of inflammation include allergic conjunctivitis (allergies in the eyes), dry eye or dysfunctional tear film syndrome (this is one of the most common reasons), a lack of sleep, over-use of the eyes, a reaction to alcohol or drug use, inflammations inside the eye (called iritis), corneal abrasions (scratches), or infections of the eye such as herpes or bacterial infections.
If this still persists I would recommend seeing a corneal specialist for an evaluation as this is precisely the sub specialist who has the most expertise with diagnosing these issues.
Does this make sense? Does this information help address your concerns? Do you have any other questions about this?
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. If you would like to ask further questions or clarification regarding anything I've said, please let me know and I will be happy to address your concerns when I return to see if you've responded. If your concerns have been resolved...
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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. Thanks for your inquiry!
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