Eye Symptoms: A Guide to Common Eye Problems

Common eye symptoms and what they mean

Itchy eyes (ocular pruritus)

"Itchy eyes" is the most searched eye symptom. Itch strongly suggests allergy, especially with watering, redness, puffy lids and sneezing. Allergic conjunctivitis is seasonal with pollen or year-round with dust mites and pets. Blepharitis and dry eye also cause itching, usually with burning or grittiness. See itchy eyes.

Red eyes

Redness comes from widened blood vessels on the white of the eye. Clues to the cause:

• With sticky discharge: conjunctivitis
• With itching and sneezing: allergy
• A bright red patch with no pain: subconjunctival hemorrhage, a harmless burst vessel
• With pain, light sensitivity and blurred vision: uveitis, keratitis or acute glaucoma, which need same-day care

See red eye.

Dry, burning and gritty eyes

Dry eye is extremely common, especially over 50, in women after menopause, with screen use and in contact lens wearers. Symptoms worsen through the day and in dry or windy places. Blepharitis often coexists.

Vision changes

Blurred vision

Gradual blurring is usually from needing glasses, presbyopia (needing reading glasses after 40), or cataract. Sudden blurring needs urgent assessment. See blurry vision.

Floaters and flashes

Floaters are specks, threads or cobwebs drifting across the vision, most noticeable against a bright sky. Most are harmless. A sudden shower of new floaters or flashes, especially with a shadow, can mean a retinal tear or retinal detachment, which needs same-day examination.

Loss of central vision

Distorted or missing central vision in older adults suggests macular degeneration. Sudden changes may mean the "wet" form, which is treatable with injections if caught early.

Loss of side vision

Glaucoma damages the optic nerve gradually and painlessly, starting at the edges of vision. Most people have no symptoms until late, which is why regular eye tests with pressure checks matter.

Eyelid symptoms

Swelling, lumps, crusting, drooping and twitching of the eyelids are common. Styes and chalazia cause lumps. Eyelid twitching (myokymia) is almost always harmless and linked to tiredness, stress and caffeine.

Eye symptoms linked to other diseases

• Diabetes: blurred vision from changing sugar levels, and diabetic retinopathy, which is usually silent until advanced
• High blood pressure: retinal changes seen on examination
• Thyroid eye disease: bulging eyes, grittiness, double vision
• Multiple sclerosis: optic neuritis with pain on eye movement and blurred vision
• Migraine: zigzag lines (aura) before a headache
• Stroke: sudden loss of vision in one eye or one side of vision
• Autoimmune conditions: uveitis with arthritis, bowel disease or psoriasis

How eye symptoms are assessed

An eye exam usually includes:

• vision testing with a chart
• pupil reactions and eye movements
• examination with a slit lamp microscope
• fluorescein dye to show surface scratches and ulcers
• eye pressure measurement
• dilating drops to view the retina and optic nerve
• imaging such as OCT scans of the retina

General eye care

• have a full eye exam every 1 to 2 years, more often over 60 or with diabetes
• wear protective eyewear for DIY, sports and chemicals
• wear UV-blocking sunglasses
• follow contact lens hygiene rules strictly
• take screen breaks: every 20 minutes, look at something 20 feet (6 m) away for 20 seconds
• do not smoke, which raises the risk of cataract and macular degeneration

Frequently asked questions

What is the medical term for eye itchiness?

The medical term for itchy eyes is ocular pruritus. It is most often caused by allergic conjunctivitis, but blepharitis and dry eye can also cause itching. Antihistamine eye drops and avoiding triggers usually help allergic itch.

What eye symptoms are an emergency?

Sudden vision loss, a chemical splash, a penetrating injury, sudden flashes and floaters with a shadow in the vision, and a painful red eye with blurred vision, halos or vomiting are emergencies. Go to the ER or an emergency eye clinic straight away.

What are the most common eye problems?

The most common are refractive errors needing glasses, dry eye, allergic conjunctivitis, infectious conjunctivitis, blepharitis and styes. In older adults, cataract, macular degeneration and glaucoma become common causes of vision problems.

Should I see an optometrist or ophthalmologist?

An optometrist can examine the eyes, prescribe glasses, and diagnose and treat many common problems. An ophthalmologist is a medical doctor specializing in eye disease and surgery. Optometrists refer to ophthalmologists when needed. Emergencies go to the ER or an emergency eye service.

Can eye symptoms be a sign of something serious elsewhere?

Yes. Eye changes can be the first sign of diabetes, high blood pressure, thyroid disease, multiple sclerosis, stroke or autoimmune disease. Sudden vision loss or double vision with other neurological symptoms needs emergency care.