Last reviewed by Dr. Raj MD on January 12th, 2022.
What does a Swollen Eyeball mean?
The inflammation of the eyeball is also known as scleritis. Unfortunately, the more inflamed the eyeball is, the higher amount of pain one will experience.
Studies have shown that the inflammation at the level of the eyeball is often found in association with different autoimmune conditions, such as rheumatoid arthritis.
The moment one experiences scleritis symptoms, it is recommended that a visit to a specialist is made. Left untreated, this condition can lead to the loss of vision, so it is very important to treat it as soon as it is possible.
The sclera is actually constituted out of fibrous tissue, covering the outer surface of the eyeball and acting as a protective layer.
According to the specialists in the field, scleritis can be classified into two main categories: anterior scleritis and posterior scleritis. Anterior scleritis is characterized by the inflammation of the frontal part of the eyeball.
This condition can be further classified into three subtypes: diffuse scleritis, nodular scleritis and necrotizing scleritis.
The diffuse scleritis is found in the majority of the patients, being however the easiest to treat. Patients who are diagnosed with diffuse scleritis experience a wide range of symptoms, with visible redness and inflammation in the anterior part of the sclera.
The second type, nodular scleritis, is less common and, as the name clearly points out, it refers to the fact that the patient presents nodules at the level of the sclera. Necrotizing scleritis presents a high risk for the destruction of the scleral tissue, being considered a rare and severe form.
In extreme situations, it can even lead to the eyeball being lost. The patients will present a number of symptoms, with tenderness or intense pain standing at the top of the list.
As opposed to the anterior scleritis, posterior scleritis is considered less common, being found on its own, without any association to autoimmune disorders. It should also be mentioned that posterior scleritis can appear at the same time with anterior scleritis.
Depending on the severity of the condition, patients present either tenderness or pain in the respective eye. The posterior scleritis presents a high risk for complications, such as glaucoma or retinal detachment.
Symptoms of a Swollen Bulging Eyeball
Because of the inflammatory process, the patients suffers mostly from the pain and tenderness that are present at the level of the respective eye. In some situations, the pain can radiate to other adjacent structures, such as the jaw, head or face (always on the side that is affected).
The swollen eyeball is also red, because of the increased blood flow into the area. Some patients might present photophobia (increased sensitivity to the light), impaired vision (the vision can become blurry) or excessive tearing. In more severe cases, the vision becomes permanently impaired (completely or partially) or the eyeball is lost.
Causes of Swollen Eyeball
As it was already mentioned, in the majority of the cases, scleritis is found in association with autoimmune disorders. Among the conditions scleritis is commonly found in association with, there are: scleroderma, Sjogren’s syndrome, Wegener’s granulomatosis, inflammatory bowel disease, connective tissue disease, lupus and inflammatory arthritis.
The eyeball can also become swollen due to infectious causes or as a direct result of an injury. In even rarer situations, scleritis is caused by a fungal or parasitic presence.
These are the most common methods used for the diagnosis of scleritis:
- Ophthalmologic examination
- Slit lamp examination
- General health assessment
- Pre-existing conditions
- Current and past treatments (including surgical interventions)
- History of recent trauma or injury
- Rheumatologic examination
- Identification of symptoms associated with various rheumatologic or autoimmune conditions
- Complete blood count
- Leukocyte levels (suggestive of an infection if increased)
- Rheumatologic factors
- Imaging studies (CT scan, MRI) – often used for the confirmation of the diagnosis.
Pictures of Swollen Eyeball
Collection of Pictures of red, inflamed swollen eyeball…
Treatment for Swollen Eyeball (Scleritis)
These are the most common methods of treatment recommended for scleritis:
- Corticosteroid treatment
- Oral administration (pills)
- Reduce the inflammation and bring the necessary relief from the pain
- Cannot be administered for prolonged periods of time, due to the negative effects on the overall health
- Non-steroidal anti-inflammatory drugs
- Oral administration
- Recommended choices – acetaminophen, naproxen, ibuprofen
- Should be administered with caution in those who suffer from chronic liver disease
- Can reduce the inflammation and also eliminate the associated pain or tenderness
- Eye solution
- Administered as symptomatic treatment – pain relief, anti-inflammatory effect
- Oral or topical administration (depending on the severity of the infection)
- The antibiotics have to be taken for as long as they are prescribed, otherwise the bacteria will develop resistance to the treatment
- It is recommended that probiotic supplements are taken at the same time with the antibiotic treatment, so as to maintain a healthy intestinal flora
- Surgical intervention
- Recommended in the more severe cases
- Purpose – repairing the damaged scleral tissue
- The surgery is the last resort in patients who suffer from severe inflammation, preventing the loss of vision from occurring
- Treatment of the underlying condition
- The administration of rheumatologic treatment, for example, can help the patient to keep the symptoms of scleritis under control.
The severity of the inflammation provides insight into the prognosis of this condition. In general, the more severe the inflammation is, the higher the risk for complications. As the patient suffers from severe inflammation, with a high risk for vision loss, the prognosis is not that positive.
On the other hand, in the situation that there are no complications and the patient manages to keep the symptoms under control, the prognosis of this condition is good.
It is also important to remember that, despite the administered treatment, it is still possible for the inflammation of the eyeball to re-appear. Patients are advised to visit their eye doctor on a regular basis, so as to reduce the risk for re-occurrences.
The more a person delays going to the doctor, the bigger the chance for associated complications. Also, it is impossible to request treatment for the underlying conditions, as keeping these under control has a positive effect on the scleritis symptoms.