Be Careful With “get the red out” Drops

 

Most of you are aware of the different drops available to help reduce the redness of your eyes:  Visine, Clear Eyes, etc..  But are you aware of the potential side effects from overuse of these drops?

These drops belong to a group of drugs called vasoconstrictors, which cause the blood vessels in the eye to shrink and reduce redness.  Sounds pretty good if you wake up and you don’t want to look like you had way too much fun last night.  But what you might not know is that unintentional abuse of these drops can lead to unintended consequences.

Contact lens wearers, especially those who sleep in their lenses should not use vasoconstrictors because narrower blood vessels carry less oxygen through the blood stream.  Many contact lenses already reduce oxygen transmission to the eye, so long term use could eventually drive you out of contact lenses all together.

Excessive drops can cause pupil dilation, which can increase light sensitivity and freak out most of the people around you who think you might have a brain tumor.  I’ve seen enough of these patients over the years (who have doused their eyes with a vasoconstrictor), that I know to ask about eye drop use as the very first question.

And finally there is actually a “rebound redness” that can occur as your eyes become accustomed to the drop.  Your eyes will actually become redder with continued use.

But the main take home message from this post is this:  If your eyes are red, there’s always an underlying reason or reasons.  And virtually all of those reasons are treatable, whether it’s dry eye, allergies, or infection.  I would rather my patients start with a good artificial tear drop like Systane or Theratears.   This may be enough to wash out the irritant that’s causing the redness.  If that doesn’t work, you can always call your friendly neighborhood eye doctor’s office…

 

About admin

Eye/vision doctor in San Antonio. Serious sports fan. Goofy dad. Husband who tries hard. Never met a bag of beef jerky that I didn't like. Except salmon. San Antonio, TX · http://eyedocdeviney.com
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    • Hi Zac,

      Thanks for reading my blog. There is a low dose steroid called Alrex that has been shown to be safe for long term use, primarily for chronic eye allergies. However, it seems that rebound redness should have stopped shortly after you discontinued the vasoconstrictor. You are most likely not treating rebound redness, but dry eyes or allergies, which I suspect is why you started using the Visine in the first place. Ask about Alrex.

  • Zac

    is there a treatment for rebound redness? I overused vasoconstrictors for about a year and now my eyes suffer constant redness, with no relief from artificial tears.

    The only thing that helped me was a short course of Flarex steroid eye drops. My eye doctor prescribed them initially and they worked wonders, completely removed the redness and gave me 100% relief. Unfortunately, long term steroid use is not an option so now I just have to suffer with red eyes all the time.

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  • Smith

    Hi! Not sure if you (Mr. Deviney) will ever get around to reading this, but unfortunately I made the foolish mistake of using Visine vasoconstricting drops for about a month and a half. My eyes would get red from contact wear so i would use a lubricating drop until I stumbled on the dream “lubricate and redness relief!”, was it my lucky day or what! Well I have been off the drops for about 5 months now and my eyes are still pretty red (Mind you they feel dry at times, but usually only real late at night/right when i wake up). My question is though, doing research most ophthalmologists give the same answer, why can’t the redness be related to the damage the drops did at the time of use verses secondary causes that get pawned off upon as the current cause of continued eye redness like dry eye or allergies? If I vasodilate the veins in my eyes enough, why should they bounce back to their former non existing/non visible selves? Thanks for your time!

    • Hi Smith! And thank you for reading. All sorts of questions come up here. As I mentioned in the post, I wonder why the redness with contact lens wear started in the first place. Were you overwearing your lenses? Or were you using a non-compatible store brand multi-purpose solution? Did you rub or rinse your lenses regulary and put them in fresh solution each night? Or did they go right out of your eyes and in to the solution each night? If you didn’t overwear your lenses, solution was good and you cleaned them as directed, then that minimizes the chance that the redness was strictly contact lens related. But these are very important questions to me. Assuming you still wear your contact lenses, then I would still want to address the questions above with you before moving on to the next possible cause of redness.

  • Smith

    Wow you are a prompt responder! Yeah sorry, i can help you with a few of those questions. My eyes in particular were very sensitive to contact wear from the get go, which is one of the first things the optometrist contact fitting woman said. I currently and haven’t used contacts for about a good 6 months. I was using Ciba Vision dailies, so each night I would just toss them away in the trash and rip out a new set the next morning. By the end of each day my eyes would be pretty blood shot, but never too badly irritated, the only thing is I would get hammered with tan mucus buildup every few hours. I’d wake up the next morning and the redness was gone. As i mentioned previously, sadly, i fell victim to vasocontrictor use about a month and a half. Only the exposed parts of my eyes and beneath the lower lid are red however, under the upper lid is white (not sure if that means anything, but I bet the more i let you know the better!) I still have tan mucus every day but it is no minute compared to what it used to be. Oh, most of my veins are actually very little compared to the few larger ones I have; there are just enough little’s combined that make (specifically my inner portion of the left eye) red. Thank you very much for you time! On a side note, is there anything you could tell my about removal of veins from the eyes? if it’s safe? Or just your thoughts on it, thanks again!

    • Smith

      Sorry, from reading my post to clarify, i never used visine redness while using contacts and “no minute” is supposed to be “so minute”. Thanks!

      • Well, to first address the idea of removing veins from the eyes…I’ve never heard of that before and I wouldn’t recommend it. Not sure you could get any surgeon to consider it either. Ok, so you wore dailies and you’ve been out of lenses for many months, but still have a little mucus every day. Your description doesn’t sound like allergies since you report no itching or tearing. You may have chronic blepharitis (kind of like dandruff of the lashes) and/or meibomian gland dysfunction. Also, are you managing any systemic health conditions? Perhaps they are manifesting themselves in the eyes?

        • Smith

          Hi Mr. Deviney, good to hear from you again. I’m pretty sure I have neither of those conditions (chronic blepharitis and meibomian gland dysfunction), I am only 22 and have no systemic health conditions. What do you think about the possibility of chemical cunjunctivitis from using the drops? Only the portion below my upper lid and lower are red, below my upper lid itself is its normal white, not sure if this is of any significance. I’ll be having an appointment with an ophthalmologist in the next month or so to talk things over. I don’t think the redness is from dry eyes since my eyes rarely feel dry and lubricating drops don’t help with the redness. They more so feel warm at times. Thanks for your help!

          • Well Smith, I think without a thorough evaluation of your eyes then I am out of suggestions. Could it possibly be from the drops? Of course it could. But it just seems unlikely to me. I will say that early signs of dry eye could be better described as reduced tear production and early meibomian gland dysfunction where your eyes are not producing tears at 100% capacity. Many people with early signs of reduced tear production do not feel any symptomes of dryness. I wish you luck with your visit to the ophthalmologist and I invite to share the results of your visit with me if you would like to. Best of luck in taking care of this!

  • Smith

    Hi Mr. Deviney, sorry for not responding earlier, I wanted to wait and see what the ophthalmologist had to say. Unbeknownst to me I was actually meeting with an optometrist who works at the ophthalmology office, but she did a great job! I told her my history, she ran a handful of tests and diagnosed me with a mild case of blepharitis (just as you thought!). From testing she determined my tear production was normal, but that the tear film could be compromised due to meibomian gland dysfunction. She proscribed me doxycycline for 30 days, suggested to use baby shampoo to rinse my lids while in the shower and to apply a few hotpresses a day. My eyes have felt much better! I had a follow up appointment today and the doctor proscribed sterilid scrubs and zaditor for itching. I don’t believe i have allergies, as you mentioned, but since my first appointment and continuing treatment I feel as though there has been a slight increase in this tan sticky mucus my eyes secrete, always when i wake up but periodically throughout the day too; i just use my finger and brush it out usually. However, my eyes are still as red as they were before, not really sure if they’ll ever get better, we’ll see in time! I’m going to keep up with the cleansing techniques, but I was wondering if you have any suggestions? Do you have any experience with steroid eye drops and if they may help reduce redness? Thanks again, it’s a pleasure talking!

    • I have prescribed steroid drops and they can definitely reduce redness. Steroid drops are often used as a first line treatment for dry eyes. Sometimes for up to 30 days and then Restasis is prescribed. Restasis is a long term treatment that has been very effective for dry eyes. It takes up to 6 weeks of continuous use in order for most patients to start to feel improvement. But most patients do get better if they stick with. You might ask your doctor about it.