Partially red eye, dull ache behind it?

[ryder9]

For the past couple weeks, my left eye has been quite veiny, but just part of it - on top of my pupil going back as far as I can see. I also have what feels like a headache behind that eye. The pain is manageable (I've had lots of headaches in my life...), but quite localized. Most days (mainly when I wake up in the AM), the top of my eye is quite veiny, I feel almost throbbing pain and pressure behind my eye and on the upper left side of my nose. And then other days, the pain is gone and the top part of my eye is just a little bit red and veiny. My vision is fine, no blurriness, and my eyes aren't teary or anything. My opthamologist doesn't have a clue what's causing it. He said it wasn't an infection or anything "wrong" with the eye, and prescribed me Lotemax to get rid of what he called inflammation, which I've been on for 2 weeks. I don't think it's helped at all. And then a day ago, my left eye got much better and now the exact same thing is happening in the right eye!

By way of completeness, a month ago I had eye problems that started out looking sort of like my eye looks now - redness on top of my left eye (but not as veiny and no pain or tearing). Over the course of a couple months, it got progressively worse - peaking with two very bloodshot, teary eyes, but still never any dull ache/throbbing. My opthamologist said I was having a bad reaction to something, possibly my contacts (maybe overuse), and prescribed Zylet, which basically solved the problem within a week. He had actually JUST cleared me to wear contacts again (but only for a day or two a week, and a different brand), saying my eyes were perfectly fine, when out of the blue my left eye got all veiny on top and aching. I haven't put contacts in for over a month. Not sure if this is related to the current problem, but I wanted to be thorough.

Oh, and I'm studying for the Bar exam this summer, so I've been stressed out and staring at computers/books for the better part of most days, which may or may not be relevant.

Any thoughts? I'm really at a loss. I don't know what's causing what, but if the headaches are causing the veiny-ness, maybe this is a question for the neurology forum? Also, I've been trying to post this in the "Ask a Doctor" forum but I always get the message that the question box is full!

Thank you so much.

[John C Hagan III, MD, FACS]

There are many things that make the eye red and veiny and a number that make it read specifically at the top of the iris. I would suggest you ask your ophthalmologist to refer you to his favorite cornea/external disease Eye MD consultant.

JCH MD

[ryder9]

Thanks so much. So you think the soreness is caused by whatever is causing the redness, and not vice versa? I'm just trying to determine whether I should see someone other than an opthamologist (maybe a neurologist or an allergist), since my opthamologist seems to think my eye is perfectly healthy, just inflammed in one part. If it is a corneal disease, would it manifest itself in only one eye at a time?

[John C Hagan III, MD, FACS]

A corneal specialist is a subspecialist consultant on inflammation on the whole outer surface of the eye. I think the soreness caused the redness not vice versa.

JCH MD

[ryder9]

Just by way of update, I had another appointment with my opthamologist today, and he thinks it's superior limbic keratoconjunctivitis. I'm having bloodwork done tomorrow to see if there's a thyroid connection. Thank you again for your help.

[John C Hagan III, MD, FACS]

SLK is a known cause of redness at the 12 o'clock limbus (where white and cornea meet.
JCH MD

[ryder9]

Thanks. To complicate things further, I've just been diagnosed by my primary care doctor with a likely sinus infection (fever, swollen glands, the works) and I'm taking antibiotics. Could the sinus infection have contributed to my eyes being red? The redness at the "12 o'clock" spot on my eyes started the same day the pain behind my eyes started (which I have now been told is due to the sinus infection that has localized near my eyes). After examining my eyes, my opthamologist has said that he doesn't have a clue why I have the dull ache behind my eyes, but that SLK could not cause the pain.

[John C Hagan III, MD, FACS]

sinus problems are a common cause of pain around or behind the eye. I think snus is unlikely to cause a localized redness at the top of the iris.

JCH MD

[ryder9]

Well, if it makes any difference, my left eye is now almost completely bloodshot - looks like the pinkeye pictures I've seen. Right eye looks fine, just two thin veins under my top eyelid. I guess I should let the antibiotics do their thing, and then if my eye is still red I should try to find a new opthamologist...

[John C Hagan III, MD, FACS]

That's a plan look for a Eye MD that specializes in cornea/external disese (disease).
Look at www.aao.org
JCH MD