Optimizing the care of the red eye patient: a new treatment direction

Eye redness may be the result or symptom of various eye diseases or may appear for no apparent reason. In the case of red eye, therapeutic treatment is based on the correct diagnosis and, if possible, on causal treatment. Therapeutic strategies in the treatment of local conjunctival hyperemia are also based on preventing vasodilation and thus reducing the red eye symptom. Vasodilation is dependent on α-adrenergic receptors. Two classes of adrenergic receptors in the eye: α1- and α2 adrenergic receptors, which are responsible for the vascular tone of the conjunctiva. The end result of binding of agonists to α1- and α2-adrenergic receptors is vasoconstriction. However, the use of vasoconstrictor drugs is associated with the occurrence of tachyphylaxis, i.e. a decrease in effectiveness with long-term use and a rebound effect defined as hyperemia, which becomes even more severe after discontinuation of treatment. The introduction of brimonidine, which is a selective α2-adrenergic agonist, into the treatment resulted in a reduction of these effects, which is also due to its effect on venous vessels and not causing the symptoms of tissue hypoxia. Compared to other vasoconstrictor drugs, it offers hope for patients with red eye symptoms to improve the local condition and their quality of life.