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It’s easy to take your eyes for granted. They help you navigate the world and require little in the way of daily maintenance. But when one or both of your eyes begin to bother you, it can become a major distraction.
So how can you tell which eye issues are no biggie and which ones indicate serious trouble?
Ophthalmologists Dr. Jennifer Yu and Dr. Lisa Olmos de Koo of the Eye Institute at Harborview Medical Center and the Karalis Johnson Retina Center at South Lake Union share the deets on which peeper problems you should never ignore.
Eye pain
Eye pain is the most obvious symptom that you shouldn’t ignore. If you’re just minding your own business and your eye suddenly starts to hurt, that’s cause for concern.
If the eye pain comes on suddenly, is severe or lasts for more than a minute or two, see an ophthalmologist right away, says Yu. [Note: an ophthalmologist is a medical doctor specializing in surgical eye procedures while an optometrist primarily focuses on routine eye care].
That’s because pain may be your eye’s way of alerting you to infection or inflammation — which means you should get it checked out.
“It’s not always easy for someone to assess the degree of injury to their own eye. And it’s not only the trauma to your eye that can be a problem, but subsequent swelling, bleeding or infection,” says Olmos de Koo.
Blurry vision
The most common cause of blurry vision is inadequate lubrication of your eyeball. (Sounds lovely, right?)
This condition is aptly named dry eye and can result from certain medications such as antihistamines, environmental factors like wind or smoke and even from wearing your contact lenses for too long. An over-the-counter product known as artificial tears (aka eye drops) usually resolves symptoms.
But before you buy anything, it’s important to note that the FDA recently recalled a plethora of generic artificial tears brands because of their potential to cause eye infections and serious sight issues.
If artificial tears don’t help, make an appointment to see an ophthalmologist within a few days.
“It may just be time to get some prescription eyeglasses, but you want to rule out the possibility of an eye disease,” says Yu.
Pregnant people are also more likely to experience dry eye because hormonal changes affect the quality of tears. If you’re pregnant, always report any changes in vision during pregnancy to your doctor because it could be a sign of gestational diabetes or high blood pressure.
If your vision blurs suddenly or you experience a severe drop in vision over the course of minutes or hours, go to the emergency room right away.
That’s because there are some serious health issues, such as inflammation of your optic nerve or very high pressure around your brain and spinal cord, that can lead to sudden vision problems.
Burning or a gritty feeling
A lack of sleep, smoke in the air, allergies or dry eye can sometimes cause a burning or gritty sensation in the eye. Artificial tears can alleviate the sensation.
“But if you suspect an object in your eye is causing the irritation, go to an ophthalmologist. Don’t get anywhere near your eyeball with a pair of tweezers,” says Olmos do Koo.
Sometimes the oil glands around your eyelashes can get blocked. And sometimes mites — yes, mites — play a role. That’s because these microscopic creatures live in and around the hair follicles of your eyelashes and feed on the dead skin cells and oils that build up there. While they occur naturally, mites can also cause eye issues when there are too many.
There’s a simple home remedy that works to unblock oil glands. Put a washcloth under hot water, squeeze it out and hold it up to your eyelids with your eyes closed for about five minutes.
If you suspect mites, add a foaming tea tree oil cleanser to your routine, gently lathering your eyelashes and then rinsing.
“Always test to make sure you’re not allergic to it first, but tea tree oil cleanser will kill the mites,” says Yu.
For this treatment to be effective, you must do it every single day for several weeks.
And if you’re still experiencing a burning or gritty sensation in your eyes after several weeks ... it’s time to make that eye doctor appointment.
Eye redness
Remember how allergies, smoke in the air and not sleeping enough can cause a burning sensation? Well, those irritants can also make blood vessels in your eye dilate and become more visible.
If your eye is red but feels fine and your vision is unaffected, you can just wait it out or use artificial tears to relieve the irritation. It’s not a great look, but it’s not a crisis.
Dramatic redness can occur if one of your small blood vessels breaks, causing a bright red patch of blood on the eye.
"It looks alarming, but it’s not. In essence, it’s just a bruise,” says Yu.
It’s when redness is accompanied by pain, burning, blurred vision, discharge or any other new symptom that you should seek out help from an ophthalmologist.
That includes pink eye, aka conjunctivitis, a highly contagious infection dreaded by preschool parents everywhere. Pink eye is redness and inflammation of the membranes covering the eye and the inner surface of the eyelids, most often caused by a virus but sometimes by bacteria.
Your eyes usually itch and have a sticky discharge, especially when you sleep. If you wake up unable to open your eye because it’s crusted together, it’s probably pink eye.
It’s always best to go to your primary care doc or an ophthalmologist to confirm your suspicion. Although viral pink eye will run its course — usually from a few days to a week — bacterial pink eye is treated with antibiotics. As difficult as it is to keep pink eye from spreading, you should refrain from rubbing or touching your eye. And you should wash your hands with warm soap and water if and when you do.
To alleviate crusting, use a clean washcloth rinsed in cold water as a compress. And don’t forget to use a new washcloth every time. Sigh.
Double vision
From an ophthalmologist’s point of view, there are two types of double vision. (Or three if the ophthalmologist is a Foreigner fan.)
If your double vision resolves when you close one eye, this could result from a neurological problem, and you should go to the ophthalmologist or the emergency room pronto.
When closing one eye doesn’t fix things, it’s likely a result of dry eye or a cataract. For this type of double vision, go to an ophthalmologist instead of the emergency room.
Droopy eyelid
As you get older, your eyelids will droop a bit from gravity and from your eye tissues naturally getting loose, but this is a gradual process and not an emergency. If one eyelid suddenly becomes droopy, though, go to the emergency room as this can be a sign of stroke, muscle disease or a nerve problem.
Odd-sized pupils
You probably know that when it’s bright, your pupil shrinks and when it’s dim, your pupil dilates.
No matter how bright or dim it is outside, your pupils should always be symmetrical. If one is suddenly quite large and the other is normal, you should go to the emergency room right away. This could indicate an aneurysm or another serious brain disease.
Floaters accompanied by flashes of light
Eye floaters are a fact of life. They’re a result of age-related changes that occur within your vitreous, the gel-like substance that fills your eyeball.
But if you suddenly notice a new set of floaters that differ from ones you’ve had before, especially when accompanied by flashes of light or obscured vision, you should go to an ophthalmologist immediately because you may have torn your retina.
As your vitreous ages, it becomes more liquid-y and, through that process, can tug on the retina. If your retina is weak, you can get a tear.
“Most of the time, a retina tear is spontaneous and not a result of injury,” says Olmos de Koo.
Eye care and prevention
Even if you’ve never experienced symptoms like these, don’t underestimate the importance of routine care for your eyes. The American Academy of Ophthalmology recommends a routine eye check by an ophthalmologist by age 40 (even if you’re one of the lucky ones without glasses or contact). Over age 40, you should get an eye exam every two to four years.
If you have diabetes, high blood pressure, high cholesterol or other health issues, you’ll want to visit an ophthalmologist more frequently. An ophthalmologist can discern the health of your eyes and the quality of your vision, as well as spot other health problems that show up in your eyes, too.
“We’ve all heard the saying, ‘Your eyes are a window to your soul,’” says Olmos de Koo. “What most people haven’t heard before is that they’re a window into your overall health, too.”
