For many years, many people have associated using tetrahydrozoline (Brand name Visine) with reducing redness of the eyes. The products with tetrahydrozoline are still on the market, and they work. However, the problem has always been that these products were never meant to be used daily, and prolonged use may cause more eye redness.
Eye redness can result from many different causes, which should not be overlooked when using eye drops to counter red eyes.
Eye drops used to whiten eyes are considered safe and effective.
Traditional eye drops used to treat redness of the eyes may cause rebound redness or worsen symptoms.
Eye drops are now available with and without a doctor’s prescription to treat redness of the eye or prevent drooping of the eyelids without many side effects.
In 2017, the FDA approved a new eye drop solution that promised to whiten the eyes. It was a low-dose form of brimonidine tartrate. This product has already been used to treat open-angle glaucoma and increased pressure in the eye (ocular hypertension), which can eventually cause damage to the eye’s optic nerve and produce vision loss.
The FDA approved yet another eye drop in 2021. Upneeq (oxymetazoline hydrochloride ophthalmic solution), a 0.1% prescription eye drop that promised amazing results but needed to be used daily. While it may sound far-fetched, Upneeq may have benefits for treating eye redness. Additionally, it also temporarily improves droopy eyelids or the condition known as ptosis.
Its use for the treatment of eye redness has shown remarkable advances. There are now safe alternatives available depending on the person’s preferences. This article will review the pros and cons of all the available options.
Red eye usually signifies inflammation
The key to treating eye redness is figuring out the cause, which can be many various things. However, the most common cause of red eye is the dilation of blood vessels in the front of the eye.
Diagnosis is usually made by determining if the involvement is in the cornea, iris, or ciliary body (the part of the eye that changes the shape of the lens). These are the front area of the eye.
Alternatively, redness may be related to the conjunctiva, whose blood vessels are more superficial. The conjunctiva is the clear, thin membrane that protects the eye and covers the inside of your eyelids and the white of your eye.
The distinction is important since redness involving the conjunctiva responds more to topical vasoconstrictors.
Common conditions that are associated with red eye include:
|Conjunctivitis||Most common form of the red eye characterized by dilation of blood vessels.|
|Blepharitis||Inflammation of the eyelids.|
|Canaliculitis||Infection caused by Actinomyces, Candida, or Aspergillus.|
|Corneal injury or ulcer||Infection, toxins, degenerative, traumatic, allergic.|
|Dacryocystitis||Inflammation of the lacrimal sac or tear duct system.|
|Episcleritis||Inflammation of the blood vessels between the conjunctiva and sclera, autoimmune.|
|Iritis||Inflammation of the middle layer of the eye, unknown causes.|
|Keratitis||Inflammation of the cornea.|
|Keratoconjunctivitis sicca||Dry eye syndrome.|
|Glaucoma||An eye condition characterized by a damaged optic nerve.|
|Subconjunctival hemorrhage||Bleeding of the conjunctiva, or below it.|
|Bacterial or viral infection||Inflammation of the cornea and conjunctiva.|
|Trauma||Inflammation of the cornea and conjunctiva; possible deeper injury to an anterior chamber with bleeding.|
Treatment of redness of the eye
The key to treating eye redness is determining the cause as quickly as possible. Uncomplicated redness can typically be managed at home or by a primary care physician without seeing an ophthalmologist.
It should be noted that all patients with acute vision changes require an ophthalmologist's evaluation to avoid any complications. However, this type of occurrence is usually rare.
Redness of the eye may not respond to over-the-counter measures. Conjunctivitis, for example, may require antibiotic drops to counter a bacterial infection or prevent superinfection with other pathogens.
Furthermore, remember that dry eyes can cause eye redness in many cases. In those cases, ophthalmic lubricants can be used to reduce redness effectively.
Lubricants for treating dry or red eyes include artificial tears and hydroxypropyl methylcellulose. The best products are preservative-free and contain potassium, bicarbonate, and other electrolytes.
Tetrahydrozoline HCL (0.05%) or Naphazoline drops
Tetrahydrozoline HCL (0.05%) drops such as VISINE are safe for use in adults and children six years or older. They should not be used in patients with narrow-angle glaucoma. These drops work by contracting the eye’s blood vessels. Important considerations include:
- They should not be used routinely because continual blood vessel constriction can cause abnormal blood vessel dilation when the medicine wears off. This rebound effect can cause redder eyes than before use.
- These drops are called sympathomimetics, but naphazoline works similarly.
- These drops should not be used with contact lenses since the lens can hold the medicine longer in the eye — both deprive the cornea of oxygen, increasing the risk of infections.
Brimonidine ophthalmic drops
The common brand name is Lumify, and these eye drops are available without a prescription. They can be used in adults and children two years old or older.
Some people may have an allergy to this medication and should stop usage if there is eye pain, watering, vision changes, dry mouth, drowsiness, or tiredness.
People should not use these drops if they have heart disease, low blood pressure, depression, or Raynaud’s disease.
Use the drops at least ten minutes prior to inserting the contact lens.
Medical professionals recommend avoiding driving or hazardous activity while using the eye drop due to possibly impaired reactions.
Oxymetazoline ophthalmic drops
These eye drops are marketed under the common brand name Upneeq. These eye drops were recently FDA-approved and touted as the first noninvasive solution for droopy eyelids, swelling of the upper eyelids, and redness of the eyes.
While these eye drops are specifically prescribed for redness of the eye, they can be used for treating eyelid conditions.
The main active ingredient in these prescription eye drops is the same as in decongestant nasal sprays, such as Afrin.
The key is that these drops can produce a wider, brighter eye without surgery. These eye drops work as an alpha-adrenergic agonist. This means that they cause the levator palpebrae muscles or Mueller’s muscles to contract and raise the upper eyelid.
The results last about six hours. The downside is that these eye drops may cause the same rebound redness, which is seen in Tetrahydrozoline HCL (0.05%) or Naphazoline drops, but that is rare.
There are rare and temporary side effects, including eye irritation, dryness, redness, headaches, and corneal inflammation.
Eye whitening eye drops can effectively treat intermittent eye redness or irritation. The products soothe the eyes by lubricating the eye's surface for quick relief of discomfort. However, seek professional medical attention for chronic or more serious eye conditions.