Diagnosing Eye Discharge by Color
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Sometimes called "sleep," "gunk," "goop," or "pus," eye discharge is a combination of mucus, oil, skin cells, and debris that tends to amass in the corner of your eyes while you sleep.
How does eye discharge form?
Eye discharge is always forming, since your eyes are constantly producing mucus throughout the day. However, when you're awake you blink, and blinking causes a continuous film of tears to "soak" your eyes, which breaks apart any mucus that would otherwise take shape in the corner of your eyes.
When you're sleeping, and therefore not blinking, the mucus has ample time to come together and coagulate in your eyes. Normal amounts of mucus typically just result in feeling mild, off-white crusting on wake-up, but anomalous conditions stemming from a number of potential causes can cause changes in mucus quantity, consistency, and color.
What is the purpose of eye discharge?
Eye discharge is actually intended to protect your eyes. Besides disposing of wasteful and potentially harmful debris from your eyes, the discharge also supports good eye health through eye rheum, which works to keep your eyes clean and moisturized in between blinks.
Some eye discharge is perfectly natural, but if you find yourself waking up with excessive amounts in your eyes, if the discharge is green or yellow, or your vision begins blurring, these may be signs of an eye infection or disease.
Excessive or abnormally-colored eye discharge may be the cause of one of the following conditions:
Probably better known as "pinkeye," conjunctivitis is a condition in which the conjunctiva, the mucous membrane covering the front of the eye and lines in the eyelids, inflames due to irritation or infection.
Conjunctivitis associated eye discharge colors
While pinkeye may manifest itself as pinkened or reddened eyes, discharge in the eye may be clear, yellow, white, or green.
The primary types and causes of pinkeye include:
- Viral conjunctivitis: This type of pinkeye is caused by viruses like the common cold. These typically aren't very harmful, and can clear up naturally without medical treatment or aid after a few days.
- Bacterial conjunctivitis: This type of pinkeye is caused by bacteria that makes its way into your eyes. Note that bacterial conjunctivitis can be severe if left untreated. Two examples of bacterial causes are staph infection and haemophilus influenzae
- Allergic conjunctivitis: This type of pinkeye affects those more prone to allergic reactions, and is caused by eye irritants like pollen or dust.
- Additional causes of pinkeye may include:
- Cat-scratch disease
- STDs like chlamydia or gonorrhea
- Dry eyes (from exposure to wind)
- Chemicals, fumes, or smoke
If you're infected with pink eye, you should wash your hands consistently, apply plenty of hand sanitizer, and avoid physical contact with other people, since pinkeye can be highly contagious.
Home remedies you can try to treat pinkeye include:
- Putting a warm compress like a towel over your eyes for a few minutes at a time: This should alleviate some pain and help break apart some of the gunk that has formed in the corners of your eyes, as well as on the eyelashes.
- Apply artificial tears solution in your eyes: This may help to mitigate itching and irritation.
If pinkeye persists and/or if you're feeling abnormally sharp pain, you may need to be treated by an eye doctor, whom may prescribe any of the following:
- Antibiotic eye drops to curb the swelling and pain: These can help prevent the infection from spreading further into your eye,
- Ocular decongestants
- Anti-allergy medicine
- Anti-inflammatory drugs
Oral or intravenous antibiotics may be prescribed if pinkeye has been caused by a sexually transmitted disease.
While there are several varieties of keratitis, the term generally refers to inflammation of the cornea, the transparent layer that forms the front of the eye.
Keratitis associated eye discharge colors
Those suffering from keratitis may experience white-colored eye discharge.
The primary types and causes of keratitis include:
- Bacterial keratitis: Bacterial keratitis usually develops quickly, and may lead to blindness if left untreated. The two main types of bacteria that cause bacterial keratitis are staphylococcus aureus and pseudomonas aeruginosa.
- Fungal keratitis: Fungal keratitis can form from an eye injury or contact lens usage. While there are innumerable fungi that may infect the cornea, the most common types are fusarium, aspergillus, and candida.
- Herpes keratitis: Herpes keratitis is caused by the Herpes Simplex Virus (HSV). There are two types of herpes, Type 1, which is more common and primarily infects the facial region, and Type 2, which is sexually transmitted and infects the genitals. While both herpes types can cause eye infections, Type 1 is by far more frequent.
- Acanthamoeba keratitis: Acanthamoeba keratitis is a very rare disease in which amoeba, a parasitic single-cell organism, penetrates the cornea of the eye. If left untreated, the infection can lead to blindness.
Keratitis treatment and relief
Treatment of keratitis may depend on which type a person has been infected with.
- Bacterial keratitis: If the infection is mild, antibacterial eye drops alone may suffice as treatment. However, if the infection is more severe, you may need to take oral antibiotics.
- Fungal keratitis: Fungal keratitis is usually treated with antifungal eye drops or oral antifungal drugs.
- Herpes keratitis: If the infection is mild, herpes keratitis is usually treated topically, or with oral antiviral drugs. In the event of a severe infection, a corneal transplant may be required.
Blocked tear duct
A blocked tear duct is when the eye's drainage system for tears is obstructed in some way, whether partially or fully. When this happens, tears can't drain normally, which causes watery, irritated, and in some cases, infected eyes.
Blocked tear duct associated eye discharge colors
If you're experiencing a blocked tear duct, thick, sticky eye discharge may appear in the color of yellow or green.
Blocked tear duct causes
There are many possible causes for a blocked tear duct. They include:
- Age: As you get older, your puncta, which is the opening that allows tears to drain, may get smaller, ultimately resulting in blockage.
- Congenital blockage: Up to 20 percent of babies are born with an underdeveloped or blocked tear duct. This may continue on into adolescence and adulthood.
- Eye Drops: Though infrequent, it is possible that certain medications like eye drops are causing blockage.
- Facial injury: If you suffer a damaging injury to the face, bone damage near the tear draining system can occur, which would hinder the process of tears flowing through the ducts.
- Tumor: Tumors by their nature may disrupt certain processes of the body. A tumor in the nose or near the tear draining system can significantly disrupt the tear duct.
- Cancer treatments: Cancer treatments like chemotherapy or radiation may cause a blocked tear duct.
Blocked tear duct treatment and relief
You can start treating a blocked tear duct by using a warm, wet towel to carefully clean your eyelids if there's tear build-up resulting in sleep/crust.
If the tear duct isn't opening properly, surgery may be required. Doctors may use small tubes to open up the passageway to fix the blockage.
For infants with blocked tear ducts, understand that the majority of the time, the tear duct will naturally open on its own by the time the infant is one year old. In the meantime, you can try gently massaging the tear duct area (inner corner of the eye) with a clean finger. Doing this may help open up the blockage.
If a blocked tear duct in an infant persists, surgical probing may be required to open it.
A corneal ulcer appears as an open sore on the cornea, which is the outer, transparent layer that forms the front of the eye. If left untreated, it can lead to defective vision and even blindness.
Corneal ulcer associated eye discharge colors
Corneal ulcers may result in thick, yellow or green-colored eye discharge. In some cases the discharge may be so thick that it impairs vision.
Corneal ulcer causes
There are two main causes of corneal ulcers:
- Bacteria: Most of the time, corneal ulcers form due to bacterial infection that seeps into the cornea. Contact lens usage is also a major culprit leading to corneal ulcers. This is because contacts can rub against the eye's surface, in turn damaging the epithelium (thin, outer layer tissue) and causing bacteria to invade the eye.
- Acanthamoeba: This is a very rare disease. Acanthamoeba are parasites that can invade the eye and cause acanthamoeba keratitis, a severe eye infection that can lead to cornea scarring and even blindness. These microorganisms are most commonly found in water (tap water, swimming pools, jacuzzis, etc.). If you wear contacts and you don't take them out before going into the pool, you can dramatically increase your risk of getting a corneal ulcer from acanthamoeba keratitis.
Other but less frequent causes of corneal ulcers may include:
- Dry eyes
- Eye allergies
- General infections
- Immune system disorders
- Multiple sclerosis
Corneal ulcer treatment and relief
A corneal ulcer has to be treated by an eye doctor. You may be prescribed antibiotic, antifungal, or antiviral eye drops. You may also have to take antifungal tablets, or be injected with medicine near the ulcer.
There are two types of dry eye. More common is simply when your eyes are not producing enough tears. The second type is when your eyes don't produce the right type of tear or tear film. Dry eye is more common among people that are 50 years of age or older.
Since dry eye is more general, eye discharge colors may appear in various colors, including clear, white, yellow, green, or light-brown.
Dry eye causes
Dry eye can be caused from a range of contributing factors, including:
- Medications: Like antihistamines, antidepressants, birth control pills, and other medicine meant to relieve or combat menopause, anxiety, Parkinson's disease, and high blood pressure
- Rosacea (inflammatory skin disease) and blepharitis (inflammatory eyelid disease): These have been known to disrupt the meibomian glands, which normally prevent evaporation of the eye's tear film.
- Dry eye is more common among adults age 50 or older: Women are also more likely than men to develop dry eye. This may be due to hormonal changes during pregnancy and/or menopause.
- Environments that are dry or windy: These can increase tear evaporation leading to dry eye.
- Seasonal changes: These can also cause dry eye, especially to those susceptible to allergies.
Dry eye treatment and relief
Dry eye typically isn't very severe, and can usually be treated in a number of ways, including:
- Artificial tears solution (eye drops): Usually referred to simply as "eye drops," artificial tears solution helps lubricate the eye to prevent or treat dryness and irritation.
- Warm compresses: For clogged meibomian glands (responsible for adequate oil secretion in the eye), try applying a warm compress to the closed eyelids of the affected eye for a few minutes at least twice a day. Doing so will soften and squeeze out the hardened meibum.
- Nutritional supplements: Researchers have found that supplements with omega-3 fatty acids can reduce dry eye. Staying hydrated with water can also relieve dry eye symptoms.
- Meibomian gland expression: Oftentimes, cases of dry eye cases stem clogged meibomian glands preventing adequate meibum (oil) secretion. In this event, an eye doctor may perform a procedure called meibomian gland expression, in which they squeeze out the clogged contents (hardened meibum and other debris) from the glands with a forceps-type tool.
Additionally, if you're experiencing dry eye make sure you:
- Blink more frequently: Every time you blink, you're essentially moistening your eye since oils and mucous secretion are being spread from your eyelid to the cornea.
- Take breaks in between phone, tablet, computer, or TV usage: Infrequent breaks can lead to straining of the eye.
- Remove eye makeup: Makeup such as eyeliner can clog the meibomian glands and lead to dry eye.
- Rinse and clean your eyelids: Wash your face with water before going to bed, including the eyelids to remove any bacteria. Add a cleanser such as premoistened eyelid wipes (sold in drug stores) to the routine to really clean out your eyes.
Dr. Rothschild has been a faculty member at Brigham and Women’s Hospital where he is an Associate Professor of Medicine at Harvard Medical School. He currently practices as a hospitalist at Newton Wellesley Hospital. In 1978, Dr. Rothschild received his MD at the Medical College of Wisconsin and trained in internal medicine followed by a fellowship in critical care medicine. He also received an MPH in 1998 from the University of Pittsburgh School of Public Health. Dr. Rothschild was a health services researcher at Brigham and Women with a focus on patient safety, quality improvement and information technology. More recently he was the Clinical Device Director for Partners Healthcare System integrating biomedical devices and physiologic monitors with the enterprise electronic health record.