Sudden Red Patch On Eye White

You wake up in the morning and look into a mirror and notice that one of your eye is red like a monster. Your friend looks curiously into your eye and ask you why your eye is so red but you are not aware of it. How could your eye turn red without you even knowing it?

There are a lot of causes for red eyes, some can be serious and some are not. If there is no preceding trauma/injury to the eye, and no symptoms such as eye pain, blur vision, fever, dry eye, itchiness or major eye discomfort, then there is a high chance that the red eye could be due to subconjunctival hemorrhage.

Conjunctiva is a thin & transparent membrane that cover the sclera (white part of eye) and inner sides of eyelids. It contains small blood vessels which are usually not clearly visible. When the conjunctiva get irritated, infected & inflamed, the vessels will become prominent as shown in conjunctivits. If the vessels break and bleed, it will lead to subconjunctival hemorrhage.

      Subconjunctival hemorrhage

There are a few causes for subconjunctival hemorrhage.

- spontaneous without a reason

- due to increased pressure: coughing, sneezing, straining, vomiting, hypertension

- due to eye injury or trauma, eye-rubbing

- due to bleeding tendency: bleeding disorders, blood thinning medicine

Other than a bright red patch with clear margin, subconjunctival hemorrhage DOES NOT come with eye pain or change in vision (except in trauma). If you have eye pain, eye discharge, blur vision, then it could be something else which could be more serious. If you have eye trauma/injury, you should see a doctor to make sure that there is no other injury. If you have multiple red patches on both eyes, then it could be due to underlying systemic disorder such as bleeding disorder.

Subconjuctival hemorrhage is generally regarded as harmless. There is no particular treatment and it can  cure by itself. The red patch will turn smaller and more pale with time, and usually heal without scar in 1-2 weeks time. If the red patch lasts for more than 2 weeks, or if you have any doubt, then it is advisable to seek medical attention.

Stye vs Chalazion

Both are swelling of the eyelids, can be upper or lower eyelids.

Stye is an infection, usually caused by bacteria in the glands of the eyelids. Chalazion is a swelling caused by blockage at the gland’s opening, thus it is not an infection. They can arise when the eye hygiene is poor, with frequent rubbing the eyes with dirty hand, contact lenses and eye makeup etc. Stye can spread to other people while chalazion can’t.

Stye will show the signs of infection, such as marked redness, pain, swelling and sometimes pus discharge, typically with a yellow dot on red swelling. Chalazion presents as swelling and redness as well, sometimes with pain and it can grow larger than a stye. They both look similar, don’t they?

    Stye: markedly red, note a yellow dot

It is not easy to differentiate between the two. However, no matter what swelling it is, if it looks more likely to be infected, antibiotics will be given.

    Chalazion: larger but mildly red

Treatment for stye and chalazion are generally similar. Since stye is a bacterial infection, it is usually treated with antibiotic eyedrops/ointment. Both conditions can benefit from warm compresses by placing a warm and wet towel over the affected eyelid for 10-15 minutes every 4-6 hours. It is advisable not to break or pinch the swelling on your own.

Stye usually can heal in a week. Whereas for chalazion, it grows and heals slowly and sometimes it can last more than a month. If it can’t heal or get worse, minor surgery can be done to drain the swelling.

Thus,

Stye = infected eyelid swelling

Chalazion = non-infected eyelid swelling

However, it is a challenge to tell whether it is infected or not…