Eye burning - itching and discharge
Itching - burning eyes; Burning eyes
Eye burning with discharge is burning, itching, or drainage from the eye of any substance other than tears.
The cornea allows light to enter the eye. As light passes through the eye the iris changes shape by expanding and letting more light through or constricting and letting less light through to change pupil size. The lens then changes shape to allow the accurate focusing of light on the retina. Light excites photoreceptors that eventually, through a chemical process, transmit nerve signals through the optic nerve to the brain. The brain processes these nerve impulses into sight.
Causes
Causes may include:
- Allergies, including seasonal allergies or hay fever
- Infections, bacterial or viral including COVID-19 (conjunctivitis or pink eye)
- Chemical irritants (such as chlorine in a swimming pool or makeup)
- Dry eyes
- Irritants in the air (cigarette smoke or smog)
Home Care
Apply cool compresses to soothe itching.
Apply warm compress to soften eye crusts if they have formed. Washing the eyelids with baby shampoo on a cotton applicator can also help remove crusts.
Using artificial tears 4 to 6 times a day can be helpful for almost all causes of burning and irritation, especially dry eyes.
If you have allergies, try to avoid the cause (pets, grasses, cosmetics) as much as possible. Your health care provider may give you antihistamine eye drops to help with allergies.
Pink eye or viral conjunctivitis causes a red or bloodshot eye and excessive tearing. It may be highly contagious for the first few days. The infection will run its course in about 10 days. If you suspect pink eye:
- Wash your hands often
- Avoid touching the unaffected eye
I'm Dr. Alan Greene and let's talk about how to put eye drops in. The problem people often have is when you tilt your head back and you see that dropper looming up there and the drops start falling down, it's a natural response to blink. You can send that drop spraying where you don't want it to go. And it can be a little uncomfortable to have that drop come down and strike your eye. If you can keep your eyes open, that's great and it works very well. But if you can't like many people, if not most people, not to worry. There's another way that works very, very well. And what you do is you'll simply tilt your head back hold the dropper right above your eyes with your eyes closed. You don't want the dropper to actually touch the eye because you can contaminate the dropper or your eye, one or the other if there's an infection involved somewhere. Just do like this - couple drops right in the corner and then blink while you're head is still up. And when you do that it will slip right in very comfortably and you'll get the whole dosage in and it works very well.
When to Contact a Medical Professional
Contact your provider if:
- The discharge is thick, greenish, or resembles pus. (This may be from bacterial conjunctivitis.)
- You have excessive eye pain or sensitivity to light.
- Your vision is decreased.
- You have increased swelling in the eyelids.
What to Expect at Your Office Visit
Your provider will get a medical history and will perform a physical exam.
Questions you may be asked include:
- What does the eye drainage look like?
- When did the problem start?
- Is it in one eye or both eyes?
- Is your vision affected?
- Are you sensitive to light?
- Does anyone else at home or work have a similar problem?
- Have you been in contact with anyone who may have COVID-19?
- Do you have any new pets, linens, or carpets, or are you using different laundry soap?
- Do you also have a head cold or sore throat?
- What treatments have you tried so far?
The physical exam may include a check-up of your:
- Cornea
- Conjunctiva
- Eyelids
- Eye motion
- Pupils reaction to light
- Vision
Depending on the cause of the problem, your provider may recommend treatments such as:
- Lubricating eye drops for dry eyes
- Antihistamine eye drops for allergies
- Antiviral drops or ointments for certain viral infections such as herpes
- Antibiotic eye drops for bacterial conjunctivitis
Follow your provider's instructions exactly. With treatment, you should gradually improve. You should be back to normal in 1 to 2 weeks unless the problem is a chronic one like dry eyes.
If your provider suspects that your eye problem may be due to COVID-19, you may need to get tested.
References
Cioffi GA, Liebmann JM. Diseases of the visual system. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 391.
Dupre AA, Vojta LR. Red and painful eye. In: Walls RM, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 10th ed. Philadelphia, PA: Elsevier; 2023:chap 18.
Rubenstein JB, Patel P. Allergic conjunctivitis. In: Yanoff M, Duker JS, eds. Ophthalmology. 6th ed. Philadelphia, PA: Elsevier; 2023:chap 4.7.
Rubenstein JB, Kelly E. Infectious conjunctivitis. In: Yanoff M, Duker JS, eds. Ophthalmology. 6th ed. Philadelphia, PA: Elsevier; 2023:chap 4.6.
Urmi UL, Willcox MD, Islam S, Kuppusamy R, Vijay AK. Ocular signs and symptoms of monkeypox virus infection, and possible role of the eye in transmission of the virus. Cont Lens Anterior Eye. 2023;46(2):101808. PMID: 36585302
Version Info
Last reviewed on: 11/8/2023
Reviewed by: Franklin W. Lusby, MD, Ophthalmologist, Lusby Vision Institute, La Jolla, CA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
