Eye redness

Other potential causes of eye redness include:

Swollen eyelid

A swollen eyelid is a very common symptom, and is usually due to allergy, inflammation, infection or injury. The skin of the eyelid is less than 1 mm thick but it is loose and stretchy, so the eyelid is capable of swelling quite dramatically. This leaflet discusses the reasons why eyelids might swell. It also links to more detailed leaflets explaining how to treat these various causes.

Dr Mary Lowth is an author or the original author of this leaflet.

Swollen eyelid causes

Inflammation (due to allergy, infection, or injury), infection and trauma can all cause swelling of the eyelids. In some cases swelling of the eyelid may be the only symptom but in others the eyelid is also likely to be red, itchy, gritty or sore.

Chalazion

A chalazion causes a lump or localised swelling in the eyelid, although it can cause the whole of the eyelid to swell, particularly if it becomes inflamed or infected.

A chalazion occurs when one of the Meibomian (or tarsal) glands in the eyelid becomes blocked, resulting in a small (2-8 mm) fluid-filled swelling (cyst). A chalazion is more common on the upper eyelid. It is not usually itchy or painful but it can be red or darker than surrounding skin. Find out more about chalazion cysts.

Chalazion

jd, Public domain, via Wikimedia Commons

Eye with upper eyelid chalazion

Stye

A stye is a common painful eyelid problem, where a small infection forms at the base of an eyelash, which becomes swollen and red, along with the surrounding edge of the eyelid.

It looks like a pus-filled spot. However, the infection and inflammation often spread back into the lid to make the whole eyelid swollen. It is usually red, as well as swollen, and can sometimes feel slightly sore. Learn more about stye infections.

External stye

By Andre Riemann, Public domain, via Wikimedia Commons

Eye with upper eyelid stye

Ectropion and entropion

An ectropion occurs when part or all of the lower eyelid turns outwards away from the eye. An entropion occurs where the lower eyelid turns in towards the eye, causing the eyelashes to rub against the front of the eye.

The eyelids can occasionally become inflamed and a little swollen, although this is not usually dramatic. Read more detail about ectropion and entropion.

Eye with ectropion

Eye with entropion

Blepharitis

Blepharitis means inflammation of the eyelids. It makes the eyes and eyelids feel sore and gritty. They are often puffy, pink-red, and a little swollen, particularly along the lid edges.

Blepharitis can be a troublesome and recurring condition, sometimes associated with other skin conditions such as rosacea and seborrhoeic dermatitis. Find out more about blepharitis.

Blepharitis

By clubtable (Own work), via Wikimedia Commons

Conjunctivitis (pink eye)

Conjunctivitis is inflammation or infection of the conjunctiva (the smooth, shiny, translucent membrane that covers the white of the eye (sclera) and the underside of the eyelids).

It can be caused by allergies and sensitivities (for example, to make-up), or by infection.

The main symptoms of conjunctivitis are redness of the eye, and a feeling of grittiness and mild soreness. As conjunctivitis affects the underside of the eyelids, it can make the eyelids puffy and a little red, either because the infection spreads into the eyelid or because the eyelid becomes inflamed or reacts in an allergic manner due to the infection. There may be some pus, or the eye may just be watery.

Bacterial conjunctivitis

By Gzzz, CC BY-SA 4.0, via Wikimedia Commons

Eyelid skin infection

Any infection in the skin of the eyelid will tend to cause marked swelling, with redness, itching and soreness. Infection can also spread to the eyelids from other parts of the face.

Infections of the skin include cellulitis, impetigo and erysipelas, which are different types of skin infection affecting different levels of the skin. A skin infection is more likely if the integrity of the skin is broken for some reason. This might include a condition affecting the skin close to the eye, such as eczema, chickenpox or shingles.

Periorbital cellulitis

By Afrodriguezg (Own work), via Wikimedia Commons

Sinusitis

Sinusitis is usually caused by a bacterial or viral infection, although it may also be caused by allergy. Sinusitis affecting the sinuses just beneath the eyes can cause puffiness around the eyes, affecting the eyelids. The eyelids are not usually red, sore or itchy.

Sinuses

Allergic eyelid swelling

Allergies occur when the body reacts to a foreign substance (called an allergen) by producing chemicals which cause swelling, redness and itching.

Eyelid swelling caused by an allergic reaction can be significant, since the eyelid tissue is stretchy and also tends to be quite ‘reactive’ to allergic stimuli. Allergic eyelid swelling is often therefore quite dramatic. The eyelids can feel tight and may even be so swollen that the eyes can’t open. Over time the extra fluid in the eyelids tends to drop downwards through the action of gravity to fill the area of the lower lid down to the top of the cheek, causing large ‘bags’ under the eyes. Sometimes overnight, when lying on one’s side, gravity results in swelling of one eyelid even though the trigger is an allergen such as pollen.

Eyelids can react in an allergic manner to various triggers, including:

Naturally occurring substances such as pollens, pet hair and organic dust.
Chemicals such as shampoo, make-up, eye drops and contact lens solution.
Infectious agents such as viruses and bacteria (which can therefore sometimes cause infection AND allergy at the same time).

Angio-oedema

This is sometimes known as angio-neurotic oedema and is a skin reaction, usually caused by an allergy, that tends to cause marked skin swelling, sometimes with itching. Mostly, it affects the eyelids and face, and sometimes the lining of the windpipe (which can make breathing difficult) and the hands and feet.

Angio-oedema

By James Heilman, MD, Own work), via Wikimedia Commons

It can sometimes be non-allergic, and be triggered by extremes of temperature, or by infections. Rarely, it can be an inherited condition. See the separate leaflet called Angio-oedema.

Anaphylaxis

Anaphylaxis, or anaphylactic shock, is a medical emergency. It is an extreme and generalised allergic reaction affecting most of the bodily systems. It can include dramatic eyelid swelling, which can be an early warning sign although it is not the most important symptom.

Anaphylaxis can cause faintness, breathing difficulties and collapse, and anaphylaxis tends to come on quickly, the full effects sometimes developing over a few minutes and usually within an hour of symptoms beginning.

Occasionally, anaphylactic reactions to food can come on more than an hour after eating the food, but this is not the usual pattern. If you have marked eyelid swelling but have no other obvious developing symptoms, you are unlikely to be developing anaphylaxis. See the separate leaflet called Anaphylaxis.

Eyelid irritation

The eyelids can become puffy, swollen and red because they are irritated by grit, dust or bonfire or cigarette smoke, without a true allergic reaction. The eyes are also usually red and watery too.

Eyelid sunburn

Sunburn of the eyelids happens easily, particularly if falling asleep lying in the sun. The lids are swollen, red and sore. Sunglasses and the use of sun cream help to protect the eyelids against sunburn.

Fluid retention due to other medical conditions

Fluid can gather throughout the body when retaining fluid – a condition called oedema. Whilst fluid retention is often noticeable in the fingers, around the lips and lower face, around the feet and ankles, and in the lower part of the back, it may also be noticed in the eyelids.

Fluid retention

By Klaus D Peter (Own work), via Wikimedia Commons

Fluid retention and tissue swelling of this type can occur because of generalised allergic reactions (see below) or due to retaining fluid because of medication or to a medical condition such as heart failure or pre-eclampsia (a condition related to pregnancy).

Intravenous fluids given as part of medical treatment can sometimes cause facial and eyelid swelling, particularly if needing to be given a lot of fluids quickly (for example, because of dehydration). This is particularly likely in someone who is unwell and has been lying flat, so that the extra fluid has tended to gather in the face and eyelids and has not yet dispersed evenly. However, generalised swelling due to medical treatment is more often an allergic reaction than an ‘expected’ reaction of this sort.

Eyelid trauma and black eye

Any direct injury to the eyelid will tend to make it swell and bruise, and the swelling is often very much worse the next day. A black eye can be caused by direct injury to the eyelid, but commonly also results from a blow to the nose or forehead. A blow to the nose often results in black eyes on both sides – and cosmetic surgery to the nose or face can have the same result.

Black eye

By Pavel Ševela (Own work), via Wikimedia Commons

The looseness of the eyelid skin means that blood can easily pool in this area after injury – and where blood pools, swelling will follow. As the black eye heals, the swelling gradually decreases, and the bruise goes through several stages before fading. It can take several weeks after this for the swelling to fully settle. See the separate leaflet called Dealing with eye injuries.

Head trauma

A significant head injury resulting in a fracture of the base of the skull, can cause two swollen black eyes, sometimes called ‘raccoon eyes’. See the separate leaflet called Head injuries.

“Raccoon eyes”

By Marion County Sheriff’s Office, via Wikimedia Commons

Facial, nose or eyelid surgery

Eyelid surgery, sometimes done to correct entropion or ectropion (see above), or for cosmetic reasons, is an example of intentional injury to the eyelids which causes bruising and swelling. The eyelids can be so swollen after eyelid procedures that the eyes are unable to open for several days.

Eyelid swelling and bruising often also results from other surgery to the nose and lower face. This is because the blood from these procedures tends to track behind the skin of the face to areas where it can pool easily causing swelling, and this includes the eyelids. The bruising and swelling can be dramatic and can take several weeks to settle down completely.

After crying

Most people will have noticed eyelid swelling after crying, particularly if this is prolonged. This occurs because the eyelids tend to absorb some of the extra tears, leading them to become temporarily swollen.

Chemical irritation and burns

Some chemicals can irritate the eyelids, causing them to swell. This can occur with some make-up products and soaps. Many people will be familiar with the eyelid irritation and swelling caused by chlorine in swimming pools. Tear gas, sometimes used to dispel crowds, causes swelling and inflammation of the eyelids, although sore and tearful eyes are the main symptoms of exposure.

Some chemicals can cause serious injury to the eyelids, beginning with swelling and pain. The causes include some everyday household chemicals such as oven cleaners, which contain strong alkali, and which might be transferred to the eyelids by rubbing the eyes.

If a chemical injury to your eyelids or eyes is suspected, they should be washed as thoroughly as possible. Run 20 litres of water over them directly from the tap, keeping running water on your open eye or eyes for 5-10 minutes, before seeking medical advice. See the separate leaflet called Dealing with eye injuries.

Remedies and treatment for a swollen eyelid

The treatment will largely depend on the cause. Further information is available by following the links to specific leaflets.

In general, treatments may include some or all of:

Cleaning the area (sometimes with diluted baby shampoo).
Using a warm wet compress.
Artificial tears (for dry eyes).
Eye drops/ointment (for allergic or bacterial conjunctivitis).
Oral antibiotics (for orbital cellulitis, though this often needs hospital admission for intravenous antibiotics).
Oral antihistamines (for allergies).
Steroid nasal spray (for hay fever or other allergies).

Patient picks for Eyelid problems

Chalazion

A chalazion is a common condition affecting the eyelid and is caused by a blockage and inflammation of a gland in the eyelid. The swelling (cyst) is usually felt as a small painless lump. It can become infected or painful. If it is causing problems and does not settle on its own, it can be medically treated with an injection or removed with a small operation.

Eye redness

Eye redness is most often due to swollen or dilated blood vessels. This makes the surface of the eye look red or bloodshot.

Considerations

There are many causes of a red eye or eyes. Some are medical emergencies. Others are a cause for concern, but not an emergency. Many are nothing to worry about.

Eye redness is often less of a concern than eye pain or vision problems.

Causes

Bloodshot eyes appear red because the vessels at the surface of the white portion of the eye (sclera) become swollen. Vessels may swell due to:

Eye dryness
Too much sun exposure
Dust or other particles in the eye
Allergies
Infection
Injury

Eye infections or inflammation can cause redness as well as possible itching, discharge, pain, or vision problems. These may be due to:

Blepharitis: Swelling along the edge of the eyelid.
Conjunctivitis: Swelling or infection of the clear tissue that lines the eyelids and covers the surface of the eye (the conjunctiva). This is often referred to as “pink eye.”
Corneal ulcers: Sores on the cornea most often caused by a serious bacterial or viral infection.
Uveitis: Inflammation of the uvea, which includes the iris, ciliary body, and choroid. The cause is most often not known. It may be related to an autoimmune disorder, infection, or exposure to toxins. The type of uveitis that causes the worst red eye is called iritis, in which only the iris is inflamed.

Other potential causes of eye redness include:

Colds or allergies.
Acute glaucoma: A sudden increase in eye pressure that is extremely painful and causes serious visual problems. This is a medical emergency. The more common form of glaucoma comes on gradually and is long-term (chronic).
Corneal scratches: Injuries caused by sand, dust, or overuse of contact lenses.

Sometimes, a bright red spot, called a subconjunctival hemorrhage, will appear on the white of the eye. This often happens after straining or coughing, which causes a broken blood vessel on the surface of the eye. Most often, there is no pain and your vision is normal. It is almost never a serious problem. It may be more common in people who are taking aspirin or blood thinners. Because the blood leaks into the conjunctiva, which is clear, you cannot wipe or rinse the blood away. Like a bruise, the red spot will change colors (usually yellow) and then go away within a week or two.

Home Care

Try to rest your eyes if redness is due to fatigue or eye strain. No other treatment is needed.

If you have eye pain or a vision problem, call your eye doctor right away.

When to Contact a Medical Professional

Go to the hospital or call 911 or the local emergency number if:

Your eye is red after a penetrating injury.
You have a headache with blurred vision or confusion.
You are seeing halos around lights.
You have nausea and vomiting.

Contact your health care provider if:

Your eyes are red longer than 1 to 2 days.
You have eye pain or vision changes.
You take blood-thinning medicine, such as warfarin.
You may have an object in your eye.
You are very sensitive to light.
You have a yellow or greenish discharge from one or both eyes.

What to Expect at Your Office Visit

Your provider will perform a physical exam, including an eye exam, and ask questions about your medical history. Questions may include:

Are both of your eyes affected or just one?
What part of the eye is affected?
Do you wear contact lenses?
Did the redness come on suddenly?
Have you ever had eye redness before?
Do you have eye pain? Does it get worse with movement of the eyes?
Is your vision reduced?
Do you have eye discharge, burning, or itching?
Do you have other symptoms such as nausea, vomiting, or headache?

Your provider may need to wash your eyes with a saline solution and remove any foreign bodies in the eyes. You may be given eye drops to use at home.

Alternative Names

Bloodshot eyes; Red eyes; Scleral injection; Conjunctival injection

Images

References

Dupre AA, Vojta LR. Red and painful eye. In: Walls RM, ed. Rosen’s Emergency Medicine: Concepts and Clinical Practice. 10th ed. Philadelphia, PA: Elsevier; 2023:chap 18.

Gilani CJ, Yang A, Yonkers M, Boysen-Osborn M. Differentiating urgent and emergent causes of acute red eye for the emergency physician. West J Emerg Med. 2017;18(3):509-517. PMID: 28435504 pubmed.ncbi.nlm.nih.gov/28435504/.

Rubenstein JB, Spektor T. Conjunctivitis: infectious and noninfectious. In: Yanoff M, Duker JS, eds. Ophthalmology. 5th ed. Philadelphia, PA: Elsevier; 2019:chap 4.6.

Review Date 8/22/2022

Updated by: Franklin W. Lusby, MD, Ophthalmologist, Lusby Vision Institute, La Jolla, CA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

Learn how to cite this page

Eye redness

Swollen eyelid

In this article :

Swollen eyelid causes

Chalazion

Chalazion

Eye with upper eyelid chalazion

Stye

External stye

Eye with upper eyelid stye

Ectropion and entropion

Eye with ectropion

Eye with entropion

Blepharitis

Blepharitis

Conjunctivitis (pink eye)

Bacterial conjunctivitis

Eyelid skin infection

Periorbital cellulitis

Sinusitis

Sinuses

Allergic eyelid swelling

Angio-oedema

Angio-oedema

Anaphylaxis

Eyelid irritation

Eyelid sunburn

Fluid retention due to other medical conditions

Fluid retention

Eyelid trauma and black eye

Black eye

Head trauma

“Raccoon eyes”

Facial, nose or eyelid surgery

After crying

Chemical irritation and burns

Remedies and treatment for a swollen eyelid

Patient picks for Eyelid problems

Chalazion

Eye redness

Considerations

Causes

Home Care

When to Contact a Medical Professional

What to Expect at Your Office Visit

Alternative Names

Images

References

Review Date 8/22/2022

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