Recurrent red eyes

Hi there,

I've been suffering from problematic eyes for long time now (10 or so) and am hoping to gain a better understanding of what's going on.

My eyes are NOT red all the time, however they are extremely prone to developing redness as soon as I get tired or if I watch and extended amount of TV. The redness does not necessarily occur in both eyes at the same time, in fact as I type this my left eye is red while my right eye is fine (however at times my right eye will be red while my left eye is fine).

The red ALWAYS originates from the inner of the eye (right or left) and extends horizontally toward my iris. When this occurs my vision does NOT suffer, however I do experience some mild pain/discomfort and the level of discomfort and redness grows the longer I'm awake  as the only thing that seems to alleviate the problem is sleep.

My vision is actually excellent as about 1 year ago I had LASIK performed, and I now have 6/4 vision in both eyes. The red eye problem has been occurring even before the surgery, at which point I wore glasses approximately 50% of the time to correct my very mild prescription. I had hoped that having my vision corrected would relax my eyes and render them less prone to developing redness however I'm disappointed to say that that has not been the case.  

Some information that may be relevant: Firstly, I actually get eyelashes in the corners of eye that touch the tissue in the very inner corner of the eye, and its possible that at times these lashes touch the corner of the eye itself (as such I pluck them). Secondly, my optometrist noted that I am a 'lazy blinker', meaning that when I blink my eye lids to do fully close thus lending the eye to dry out. He used a yellow dye test to determine that I had some scratching/cells missing from the bottom edges of my cornea and advised that I use a lubricating eye drop (systane). Since using the eye drops however I'm told the corneal scratching has healed and yet I still have the red eye problem.

A saw that a fellow forum member posted the picture in the link below. My eyes develop much the same condition, however the redness of my eyes is more intense and 'blurred' rather then being confined to discrete blood vessels.

http://img49.imageshack.us/img49/7035/eyery2.jpg

Using eye drops to clear up red eyes does help and typically will be able to remove about 80% of the redness. When such drops have been applied, the 'blurred' redness goes away but what remains are the major bloods vessels, which constitute the persisting redness of the eye, similar to what's pictured above.

I almost wish there was a way to cortorise (spelling?) the blood vessels or something around the side of the eyeball so that the inflammation could need extend all the way around to my iris, but from what I understand the redness occurs because the eye is trying to heal itself and is therefore a good thing.  

Is this another classic case of episcleritis to be treated by topical steroids? I've been to an optometrist about the issue and have simply been told that 'it's normal', but it sure as hell doesn't feel or look normal when you consider that none of my friends/family have this issue.  

Any insights or suggestions would be greatly appreciated. Thanks

[John C Hagan III, MD, FACS, FAAO]

Forget seeing the optom and see an ophthalmologist, perhaps your lasik surgeon. Possibilities include recurrent epscleritis or pingueculitis or mechanical irritation due to trichiasis (aberrent eyelashes rubbing eye).

JCH MD