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Eye burning - itching and discharge

Itching - burning eyes; Burning eyes

Eye burning with discharge is burning, itching, or drainage from the eye of any substance other than tears.

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Causes

Causes may include:

• Allergies, including seasonal allergies or hay fever
• Infections, bacterial or viral including COVID-19 (conjunctivitis or pink eye)
• Chemical irritants (such as chlorine in a swimming pool or makeup)
• Dry eyes
• Irritants in the air (cigarette smoke or smog)

Home Care

Apply cool compresses to soothe itching.

Apply warm compress to soften crusts if they have formed. Washing the eyelids with baby shampoo on a cotton applicator can also help remove crusts.

Using artificial tears 4 to 6 times a day can be helpful for almost all causes of burning and irritation, especially dry eyes.

If you have allergies, try to avoid the cause (pets, grasses, cosmetics) as much as possible. Your health care provider may give you antihistamine eye drops to help with allergies.

Pink eye or viral conjunctivitis causes a red or bloodshot eye and excessive tearing. It may be highly contagious for the first few days. The infection will run its course in about 10 days. If you suspect pink eye:

• Wash your hands often
• Avoid touching the unaffected eye

When to Contact a Medical Professional

Contact your provider if:

• The discharge is thick, greenish, or resembles pus. (This may be from bacterial conjunctivitis.)
• You have excessive eye pain or sensitivity to light.
• Your vision is decreased.
• You have increased swelling in the eyelids.

What to Expect at Your Office Visit

Your provider will get a medical history and will perform a physical exam.

Questions you may be asked include:

• What does the eye drainage look like?
• When did the problem start?
• Is it in one eye or both eyes?
• Is your vision affected?
• Are you sensitive to light?
• Does anyone else at home or work have a similar problem?
• Have you been in contact with anyone who may have COVID-19?
  
• Do you have any new pets, linens, or carpets, or are you using different laundry soap?
• Do you also have a head cold or sore throat?
• What treatments have you tried so far?

The physical exam may include a check-up of your:

• Cornea
• Conjunctiva
• Eyelids
• Eye motion
• Pupils reaction to light
• Vision

Depending on the cause of the problem, your provider may recommend treatments such as:

• Lubricating eye drops for dry eyes
• Antihistamine eye drops for allergies
• Antiviral drops or ointments for certain viral infections such as herpes
• Antibiotic eye drops for bacterial conjunctivitis

Follow your provider's instructions exactly. With treatment, you should gradually improve. You should be back to normal in 1 to 2 weeks unless the problem is a chronic one like dry eyes.

If your provider suspects that your eye problem may be due to COVID-19, you may need to get tested.

References

Cioffi GA, Liebmann JM. Diseases of the visual system. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 395.

Dupre AA, Wightman JM. Red and painful eye. In: Walls RM, Hockberger RS, Gausche-Hill M, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 9th ed. Philadelphia, PA: Elsevier; 2018:chap 19.

Loffredo L, Pacella F, Pacella E, Tiscione G, Oliva A, Violi F. Conjunctivitis and COVID-19: A meta-analysis. J Med Virol. 2020;92(9):1413-1414. Epub 2020 May 22. PMID: 32330304 www.ncbi.nlm.nih.gov/pmc/articles/PMC7264785/.

Rubenstein JB, Spektor T. Allergic conjunctivitis. In: Yanoff M, Duker JS, eds. Ophthalmology. 5th ed. Philadelphia, PA: Elsevier; 2019:chap 4.7.

Rubenstein JB, Spektor T. Conjunctivitis: infectious and noninfectious. In: Yanoff M, Duker JS, eds. Ophthalmology. 5th ed. Philadelphia, PA: Elsevier; 2019:chap 4.6.

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Review Date: 12/9/2021  

Reviewed By: Franklin W. Lusby, MD, Ophthalmologist, Lusby Vision Institute, La Jolla, CA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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