Trucker MD
The red eye
Most people think of "the red eye" as the flight from Los Angeles to New York, leaving late in the evening and arriving early in the moring. For truckers, "red eye" has another meaning and it's been common in trucking since drivers wore goggles to keep the bugs off their eyeballs.

By John McElligott, MD
with Jeffery Heinrich, Ed.D., PA-C


Guess what one of the biggest causes of the red eye is in truckers? It’s a combination of chronic irritation/dry eye and recurrent low-grade infections of the eye. It’s generally simple to treat a case of red eye, as moisturizing drops will stop the irritation in just a few hours.

Red eye that is not relieved by moisturizing drops needs to be evaluated by a medical provider or eye specialist. A case of red eye could be something more significant. Drivers could be suffering from conditions such as high blood pressure and diabetes, both of which can cause blindness.

So when a trucker has a case of red eye or eyes, how does the doctor determine a course of action? First, I define the patient’s history with the following eight questions:

  • Onset of redness?
  • Vision changes?
  • Itching or pain?
  • Tearing or discharge (clear or pus)?
  • Sensitivity to light with or without pain?
  • Trauma, recent or remote?
  • Exposure to caustic chemicals?
  • Contact lens use or overuse – i.e., while asleep?

Then I review the patient’s medical history and “the systems.” This means reviewing everything from head to toe.

While discussing the head and/or eyes, I always ask about symptoms – for example, associated headaches or double vision – that give some idea as to whether there is a disease such as glaucoma. Allergy symptoms, upper respiratory or gastrointestinal problems are also reviewed. These may be related to an undiagnosed medical problem that could have been overlooked in the past.

So when does a case of common red eye turn serious? Here are some conditions that will not go away on their own and that will need to be treated by a medical professional.

  • When the red eye has changes in vision;
  • The red eye has a persistent pus discharge and the eyelids are matted together upon waking in the morning;
  • The eyelid has a swollen pustule that is painful and causing vision problems because of the swelling;
  • Sensitivity to light in either eye, especially if the red eye hurts when shining a light into the good eye;
  • Trauma of the eye globe with loss of vision;
  • Trauma followed by floaters drifting across on visual fields, or loss of a visual field;
  • Unexplained pain when at rest or touching the eye globe; and/or
  • History of diabetes and a red eye that becomes a blind eye in any of the quadrants of vision.

When one or both of your eyes present a condition like the ones mentioned above, it’s critical that you pay attention and get treatment. Eyes are delicate organs and much – including your driving career – depends on their ability to function at their optimum level. LL

Editor’s note: John McElligott is an M.D. and Fellow of the American College of Physicians. Jeff Heinrich, who serves as the column’s medical editor, has a Doctor of Education degree and PA-C, which means Physician Assistant-Certified.