Oh, Something is wrong with my eye!" We have all said this at some time. How uncomfortable it can be! Fortunately, many common eye (ocular) disorders disappear without treatment or can be managed by self-treating. Various products--from artificial tears and ointments to ocular decongestants--are available over-the- counter (OTC). These products can help with dryness, itching, or excessive watering of the eye. However, a word of caution: in some instances, what may seem like a minor eye problem may lead to a severe, potentially blinding condition.

Many safe and effective OTC products for eye disorders are available for self-treatment. Two important factors to remember when considering self-treatment are: (1) if the problem appears to involve the eyeball itself, you should consult a physician immediately; and (2) if you use an OTC eye care product for 72 hours without improvement of the condition being treated or the condition worsens, you also should see a doctor immediately.

To self-treat common ocular disorders with OTC eye care products, viewers should understand: (1) the structure of the eye; (2) the cause of the disorder; (3) which disorders are safe to self- treat and which should be referred to a physician; (4) the types of OTC eye care products that are available and the disorders in which they are useful.

The eyes are complex sensory organs. They are designed to optimize vision under conditions of varying light. Their location, on the outside of the face, makes them susceptible to trauma, environmental chemicals and particles, and infectious agents. The eyelids are the major protective mechanism for the eye.

The eye consists of the eyeball, the upper and lower eyelids, and the conjunctivas. The eyeball consists of a clear, transparent dome at the front (the cornea) that is surrounded by the white of the eyeball (the sclera). The iris of the eye is the circular, colored portion within the eyeball and behind the cornea, and the pupil is the central opening within the iris. Behind the iris and pupil is the eye's lens.

The inner sides of the eyelids which touch the eyeball, are covered by a thin membrane (the palpebral conjunctiva) that produces mucus to lubricate the eye. This thin membrane folds back on itself and covers the visible sclera of the eyeball. (This continuation of the palpebral conjunctiva is called the bulbar conjunctiva.) The tissue between the skin of the eyelid and the palpebral conjunctiva is filled with glands that secrete sebum, an oily substance that provides additional lubrication for the eye. Tears are formed by the lacrimal gland in the upper, outer corner of the eye and are collected and drained by the lacrimal sac in the inner, lower corner of the eye. Natural oil for the tears is produced by tiny glands located at the edges of the eyelids.


Blepharitis: Blepharitis is a common condition that is caused by inflammation of the eyelid. It results in red, scaly, and thickened eyelids and typically some loss of the eyelashes. Blepharitis may be due to either Staphylococcus epidermidis or Staphylococcus aureus (types of bacteria), or seborrheic dermatitis (a type of skin inflammation of unknown cause), or a mixture of the two. The most common complaints are itching and burning. Blepharitis is initially treated by applying hot compresses to the affected eye, followed by an eyelid scrub. If the condition persists, you should see the doctor, who may prescribe antibiotics.

Lice: The eyelids can become infested with one of two different lice, the crab louse (Phthirus pubis) or the head louse (Pediculus humanus capitis). Lice in the eyelids cause symptoms and signs that are similar to those of blepharitis (red, scaly, and thickened eyelids, usually with some loss of the eyelashes). Petrolatum or a non-medicated ointment is applied to the eyelid and suffocates the lice eggs. RID, NIX, A-2000 or any other preparation that is designed for use in the hair should not be used near the eyes.

Contact dermatitis: Contact dermatitis is an inflammation of the skin that causes swelling, scaling, or redness of the eyelid with intense itching. This condition usually is triggered by the use of a new product (soap or make-up) or exposure to a foreign substance. If both the upper and lower eyelids are affected, the cause of the inflammation is likely to be an allergic reaction. Antihistamines that are taken by mouth can be used to treat contact dermatitis of the eyelid.

Foreign substance: Lint, dust, an eyelash or other foreign matter can become stuck in the eye. When the substance cannot easily be removed either with your finger, water, or an ophthalmic irrigant, a doctor should be seen.

Thermal damage: Thermal damage is a burn injury to eye itself. Exposure to the sun's UV radiation during outdoor activities is an example of minor ocular thermal damage. An eye lubricant can be applied to soothe the eye. If there is no relief to the eye after 24 hours, a physician should be seen. An injury to the eye, for example, from a welder's arc, warrants the immediate attention of a doctor.

Conjunctivitis: Bacteria, virus, allergy, or inflammation- promoting agents can cause inflammation of the palpebral and bulbar conjunctiva, also known as conjunctivitis. The inflammation causes enlargement of the blood vessels in the conjunctiva ("congestion") and causes the conjunctiva to become red ("blood-shot"). Itchy eyes may or may not accompany the inflammation. The congestion and itchiness can be treated with ocular decongestants, but the underlying cause may need treatment as well.

Dry eye: Dry eye is characterized by a white or mildly reddened eye combined with a sandy, gritty feeling. Unlike the name implies, dry eye is accompanied by excessive tearing. Abnormalities of the tears or the lubricants of the eye themselves are thought to reduce the effectiveness of the lubrication. The resulting inadequate lubrication stimulates an increase in the production of tears. Other factors thought to contribute to dry eye are aging and some drugs such as antihistamines, antidepressants, or diuretics (water pills). A different type of dry eye can occur when the flow of tears is reduced because of inflammation and destruction of the lacrimal glands (keratoconjunctivitis sicca). Although lubricants are effective for treating dry eye, a physician also should be consulted.

Hordeolum: Commonly referred to as a sty, a hordeolum is an inflammation of the glands within the eyelid. The primary sign of a hordeolum is a tender, raised nodule on the eyelid. Sometimes, the eyelid is so swollen that the eye appears to be completely shut. A hordeolum is usually caused by the same bacteria that are linked to blepharitis. Treatment usually is with hot compresses several times per day, but if the problem worsens or does not clear within a week, a physician should be seen. Antibiotics may be necessary.

Chalazion: A chalazion looks similar to a hordeolum. A chalazion is a raised nodule without the tenderness of a hordeolum. Like a hordeolum, it is treated with hot compresses. If the chalazion persists, a physician should be consulted.

Trauma: Blunt trauma to the eye requires immediate evaluation by an ophthalmologist or optometrist. Trauma to the eye can activate bleeding into the eye from ruptured blood vessels or cause detachment of the retina. Both situations can seriously impair vision. 

Abrasion: An abrasion usually occurs when a fingernail or metallic foreign object rubs across the cornea or conjunctiva. There is a risk of bacterial or fungal contamination and infection following an eye abrasion.

Chemical exposure: Exposure of the eye to household cleaning solutions, fumes, or an actual chemical splash requires immediate evaluation by a physician, though initially it may be self- treated with water or an irrigant.

Keratitis: Keratitis is an inflammation of the cornea that may occur alone or simultaneously with conjunctivitis. The symptoms of keratitis include blurred vision, pain, and intolerance to light (photophobia).

Corneal swelling: Corneal swelling, or edema, is a condition in which fluid accumulates in the cornea. The edema causes visual disturbances such as halos or starbursts around lights. Reduced vision may or may not occur. Corneal swelling can arise as a complication of contact lenses, surgical damage to the cornea, or an inherited defect. Hyperosmotics are used to treat corneal swelling, but additional treatment by a physician may be necessary.

Uveitis: Uveitis is an inflammation of the eye structures in the uveal tract (the iris and other structures within the eye to which the iris attaches). Uveitis may occur without an obvious cause or may be due to trauma or an inflammatory disease in other parts of the body. Symptoms and signs of uveitis are similar to those of conjunctivitis and keratitis.

Angle-Closure Glaucoma: This disorder usually is triggered after an eye exam in which the pupils have been dilated. Angle- closure glaucoma is due to an obstruction of the canal system that drains fluid from the inside of the eye. As a result, fluid accumulates and the pressure within the eye increases. Patients may have a tendency to develop angle-closure glaucoma because of an anatomical defect in their eye. Common symptoms include an aching eyebrow or a headache that leads to nausea and vomiting. Angle-closure glaucoma should be suspected if symptoms develop after an agent is used to dilate the pupils for an eye exam.