Why are my eyes red and tearful? Do I have conjunctivitis?

If you have red eyes and tears, you should be alert to whether you have conjunctivitis. This disease can cause decreased vision, increased eye secretions, and a foreign body sensation. It requires timely diagnosis and treatment, and you should protect your eyes at ordinary times.

1. Symptoms

The affected eye may experience a foreign body sensation, burning sensation, heavy eyelids, and increased secretions. When the lesion involves the cornea, photophobia, tearing, and varying degrees of vision loss may occur.

2. Physical signs

The signs of conjunctivitis are an important basis for the correct diagnosis of various conjunctivitis.

(1) Conjunctival congestion The characteristic of conjunctival vascular congestion is that the closer to the dome, the more obvious the congestion. The blood vessels are distributed in a reticular manner and are bright red in color. They can extend into the periphery of the cornea to form corneal pannus. The congestion disappears quickly after the application of epinephrine.

(2) Purulent discharge is common in gonococcal conjunctivitis; mucopurulent or catarrhal discharge is common in bacterial or chlamydial conjunctivitis, and often adheres firmly to the eyelashes, making it difficult to open the eyelids in the morning; watery discharge is usually seen in viral conjunctivitis.

(3) Conjunctival edema. Conjunctival inflammation causes conjunctival blood vessel dilation and exudation, leading to tissue edema. Because the bulbar conjunctiva and fornix conjunctiva tissues are loose, they bulge out significantly when edematous.

(5) The papilla is a nonspecific sign of conjunctival inflammation and can be located on the palpebral conjunctiva or corneal limbus. It presents as a raised polygonal mosaic appearance with areas of hyperemia separated by pale grooves.

(6) Follicles Follicles are yellow-white, smooth, round protrusions with a diameter of 0.5 to 2.0 mm. However, in some cases, such as chlamydial conjunctivitis, larger follicles may also appear. Viral conjunctivitis and chlamydial conjunctivitis are often accompanied by obvious follicle formation and are called acute follicular conjunctivitis or chronic follicular conjunctivitis.

(7) Membrane and pseudomembrane Membrane is a cellulose exudate attached to the surface of the conjunctiva. Pseudomembrane is easy to peel off, while true membrane is not easy to separate. After forced peeling, the wound will bleed. The essential difference between the two lies in the difference in the degree of inflammatory response. The inflammatory response of true membrane is more severe. Corynebacterium diphtheriae causes severe membranous conjunctivitis; β-hemolytic streptococci, Klebsiella pneumoniae, gonococci, adenovirus, inclusion bodies, etc. can all cause membranous or pseudomembranous conjunctivitis.

(8) Damage to scar matrix tissue is the histological basis of conjunctival scar formation. Early manifestations of conjunctival scarring include narrowing of the conjunctival fornix and subepithelial fibrosis of the conjunctiva.