Q.    What causes small red spots on the white part of the eye?
Bright red spot(s) on the white part of the eye are probably subconjunctival hemorrhage(s).  These are caused by a number of things including injury or may develop spontaneously in older adults.  You should see an Ophthalmologist for a diagnosis and treatment if applicable.

Q.    What causes red eye?
Red eye is caused when the blood vessels of the eye swell with more blood than usual.  Red eye may be associated with:

Q.    What causes black floating spots in my vision?
Floaters are condensations of cells in the gel part of the eye, known as the vitreous.  Floaters appear as dark spots, as web-like objects, as a dot with arms, or strings.  Floaters are often associated with high myopia (very nearsightedness) and with aging.  A lot of floaters my be a sign of serious eye disease such as a retinal break, tear, or retinal detachment.  If you see a lot of floaters, suddenly, or see bright dots or flashing lights, you need to see an Ophthalmologist immediately.  There is no treatment available for typical, nonpathologic, floaters.  Also see Vitamin A and Floatersin this section.

Q. What is "pink eye"?
Pink eye is a conjunctivitis caused by Koch-Weeks bacillus - a bacterial infection.  It is very contagious and causes wide spread epidemics, particularly in warm climates.  Once infected, the incubation period is 24 to 48 hours and is followed by an acute onset of inflamed, redness, and discharge of mucus and pus from the eye.  The patient often complains, if old enough, of scratchy, burning and pain of the eye and eye lid.  Subconjunctival hemorrhages are common and in some cases corneal ulcers may appear.  The infection reaches its peak in 3 to 4 days.  If you or your child has pink eye, immediate medical attention is needed.  Untreated patients often have recurrences of the disease.  Attention to personal hygiene is recommended.  See your eye doctor.

Q.    My eyes are very dry.
Dry eye disease (Keroconjunctivitis sicca) is a common and very frustrating disease to deal with in the aging population.  It typically affects women and symptoms include a dry, gritty sensation as well as foreign body sensation in the eye(s).   There are many causes of dry eye disease including the decrease in hormones with advancing age and reduction in eye tear production, sometimes associated with other disease.  Unfortunately, treatment options are limited, in part, because of the number of diverse factors that cause the disease.  Artificial tears and ointments provide temporary relief.  Better treatments will become available through research, some of which is being undertaken at the College of Optometry at The Ohio State University with support from the Ohio LIONS Eye Research Foundation. 

Q.    What is the difference between an Optometrist and an Ophthalmologist?
An Optometrist (designated as an O.D.) is an eye doctor whose is trained in the optical correction of the eyes with contacts or glasses, diagnosis and treatment of eye problems and eye diseases, and who may be trained and certified in the use of diagnostic and therapeutic drugs.  To become an Optometrist, you need a 4-year bachelors degree and three to four years of post graduate work at a college or department of Optometry.  An Ophthalmologist is a medical doctor (designated as an M.D.) or Osteopathic doctor (designated as a D.O.) whose is trained in the optical correction of the eyes with contacts or glasses or surgery, diagnosis and treatment of diseases of the eye and body, uses diagnostic and therapeutic drugs, and performs surgery.  To become an Ophthalmologist, you need a 4-year bachelors degree,  4-year medical degree, 1-year internship and three to four years of residency training specifically in Ophthalmology.  Optometrists and Ophthalmologists may have additional year(s) of training in a specialty area such as pediatrics.

Q.    My child's eyes appear to really turn-in when he looks at close objects.
Your child may have an accommodative esotropia - this condition occurs when a child looks at near objects and the eyes turn-in too far, making their child appear cross-eyed (esotopic).  This may be a sign that your child needs glasses for seeing things close-up.  If left untreated the child may develop a lazy-eye.  You should see a Pediatric Eye doctor for evaluation and treatment.

Q.    My father complains periodically of   sharp pains in his eye, almost like that caused by a needle.  Can you explain?
Sharp pains in the eye may be an early sign of glaucoma - abnormally increased pressure in the eye that can lead to blindness.  The presence of glaucoma increases with age.  Your father should see an eye doctor ASAP for a complete eye exam which should include the measurement of the pressure of the eye.   If caught early, medicines and/or surgery may prolong sight.
Q.    I've been taking a lot of iron [Niacin] tablets for ... and I've noticed lately that my vision is blurred.  Any connection?

Yes, there my be a connection between your blurred vision and Niacin.  About 10 years ago several case reports were published (Millay et al, 1988 in the journal Ophthalmology) about patients who were on large (3 - 4.5 grams per day) amounts of Niacin and complained about blurred vision.  Most of the patients were found to have swelling of the central part of the retina - the macula.  Stopping the Niacin cleared-up the vision problem.  If you are taking large amounts of Niacin and experience any vision problems, please see your eye doctor.
   What could cause half of my eye to [become] red?  No itchiness, soreness or irritation.
If you wear contacts you could have contact lens induced keratopathy, which may first involve the upper part of the eye.  If so, you need to stop wearing contacts immediately and see an eye doctor.  If left untreated or/and you continue to wear contacts you could permanently loss vision in the affected eye.  See an eye doctor.

 Q.    I have painful, itchy, swollen eyes.  Also, probably unrelated, swollen, itchy feet.
The two are, in fact, possibly related and may be signs of an allergic reaction.  If you are taking medicine(s), ask your doctor if the medicine(s) can cause an allergic reaction.  Cosmetics, environmental irritants, dyes, certain foods, etc., can cause an allergic reaction as you described.  Whenever there is pain involved see your eye doctor ASAP. 

Q.    The whites of my eyes are a very yellow color.  What's the cause?
Yellow eyes and/or skin may be a sign of jaundice and the deposition of excessive bilirubin in those tissues.  If the white parts of your eyes are yellow, it may be a sign of jaundice and associated liver disease.  You should see a medical doctor (Ophthalmologist, internist or general practitioner) ASAP to evaluate you for liver disease ( a simple blood test).  Numerous diseases can cause jaundice in adults including hepatitis and alcohol cirrhosis.

Q.    My eyes water quite a bit, especially when I first wake up, or while I'm going to sleep.  If I'm indoors for quite a while and go outside on a sunny day, my eyes really water and I need to close my eyes for a while.  What causes this?
Excessive tearing is sometimes a way for the eyes to "flush-out" irritants, including cold, light, cosmetics and foreign bodies.  Particular attention should be placed on anything that can cause corneal irritation, including foreign bodies and even eye lashes that turn inward.   Excessive tearing is sometimes also caused by certain drugs, such as pilocarpine.   Finally, patients with anterior uveitis sometimes complain about excessive tearing, particularly when exposed to bright lights - like going from indoors to the outdoors.   See an eye doctor to rule-out a potentially treatable problem.

Q.    I have double vision.   If I close one eye things look fine but with both eyes open there are two images, one over the other.
Double vision, or diplopia, is sometimes associated with an eye misalignment or strabismus.  If one image looks like it is above the other than the eyes would have a vertical misalignment or vertical strabismus.  Sometimes diplopia is the result of the eyes failing to maintain alignment (and binocular single vision) due to fatigue or/and age factors; when the person was younger he/she was able to maintain single vision with some effort and eye strain.  Diplopia is also sometimes caused by an inability to converge the eyes for close work (accommodative insufficiency) resulting in double vision for close objects.  Diplopia is also a sign of a possible serious eye or neurological problem.  You should see an eye doctor about the diplopia ASAP, particularly if it is a recent development.

Q.    Are contact lenses harmful to the eyes?
As long as you follow the directions for proper use of the contact lenses and follow your doctor's orders then contacts are very safe.  Problems arise when patients do not follow proper use and care directions for the contacts and when they ignore the doctor's orders.  Because the corneas need to breath and have oxygen, some problems arise when patients wear contacts for too long.  Problems also arise when patients do not follow proper cleaning and sanitary instructions and infections develop.   These can be nasty infections that cause permanent loss of sight.  DO NOT put contacts in your month to clean them and DO NOT remove contacts from your eyes and then put them back in unless they have been cleaned.  Also, always wash your hands before handling your contacts.  Finally, not everybody can wear contacts; particularly people with dry eye disease.

Q.    Lights hurt my eyes at night.   Why?
Sensitivity to light or photophobia is caused by a number of factors including the early formation of cataracts or glaucoma, to name a few.  Any disease process that affects the front part of the eye; for example, either the cornea or the lens of the eye can cause photophobia.  Certain retinal conditions also cause photophobia.  See an eye doctor for evaluation and treatment, if applicable.

Q.    Blood in eye?
Patients have blood in the eye either because of injury or disease.  If the blood is in the front part of the eye, in front of and partially blocking the iris (colored part of the eye that makes the pupil), it is referred to as a hyphema.  A hyphema requires immediate medical attention and if left untreated could lead to an onset of glaucoma and blindness in the eye.  Blood in the back part of the eye, where the retina is, is usually caused by disease, such as diabetes, although trauma (e.g., shaken baby syndrome) can also cause retinal/vitreous bleeding.  Whatever the cause, blood in the eye requires immediate medical attention.  If there is blood inside the eye, depending on the situation, the eye doctor may wait for it to clear or may need to undertake surgery (vitrectomy) to remove the blood.