No matter what I do, I constantly have red eyes. You can always see the veins in my eyes. I get enough sleep and I have tried many different lubricants for the eye. My eyes don't feel dry, and I am not allergic to anything. This has been going on for many years. At first I thought it had to do with my contacts, but I recently had LASIK and I still have the same problem. I have heard of having the inferior punctum closed. What does that mean?

Kim

First, it's important to realize that the blood vessels in the eye should be visible. I've had patients who were convinced that the "whites" of their eyes should be absolutely white. In fact, using certain medications (such as Visine) to constrict the blood vessels and make them less visible can result in "rebound redness." That is, the blood vessels tend to dilate (becoming larger and more visible) after the medication wears off. This can become a chronic cycle in people who regularly use such medications.

Chronic redness is generally caused by some type of irritation to the eyes. The most common causes include dry eyes and ocular allergies.

Dry eyes may or may not produce eye irritation. So, not all people with dry eyes actually "feel" like they have dry eyes. There are many kinds of lubricating drops available to treat mild cases of dry eyes. In severe cases, preservative-free lubricating drops are more effective.

As you mentioned, people with severe dry eyes may also benefit from punctal occlusion. In this procedure, a small plastic "plug" that looks like a miniature golf tee is placed in one of the two ducts that lead from the eye to the nose. This prevents tears from flowing into the nose, and thus allows the tears to stay in the eye longer.

Allergies are another common cause of chronic red eyes. The optimal treatment is to keep the patient away from whatever is triggering the allergic reaction. However, the cause of the allergy usually cannot be determined. If your ophthalmologist suspects ocular allergies are the cause of your red-eye condition, he or she may recommend anti-allergy medications.

LASIK is a laser procedure that is effective at reducing or eliminating the need for glasses and contact lenses. People with dry eyes who undergo LASIK will often experience a worsening of their condition that generally lasts for a few weeks to months. Otherwise, LASIK should not influence a person's eye redness.