From the Guidelines
The treatment for a swollen eye should ideally be directed at the root cause, and early detection and treatment can be both sight-saving and, in select cases, life-saving 1. To address the swelling, it's essential to consider the underlying cause, which could range from allergies to infections.
- Applying a cold compress to the affected eye for 10-15 minutes several times daily can help reduce inflammation and swelling.
- Over-the-counter antihistamines like cetirizine (10mg daily) or diphenhydramine (25-50mg every 6 hours) can be beneficial if allergies are the cause of the swelling.
- For mild irritation, artificial tears such as Systane or Refresh can provide relief.
- If an infection is suspected, it's crucial to avoid touching or rubbing the eye and to remove contact lenses if worn.
- Seeking medical attention is necessary if the swelling is severe, painful, affects vision, or doesn't improve within 24-48 hours, as prescription medications may be required.
- Bacterial conjunctivitis might necessitate antibiotic eye drops like tobramycin or erythromycin applied 4 times daily for 7-10 days, while severe allergic reactions might need steroid eye drops.
- Elevating the head while sleeping can help reduce morning swelling by preventing fluid accumulation around the eyes. It's also important to note that indiscriminate use of topical antibiotics or corticosteroids should be avoided because antibiotics can induce toxicity, and corticosteroids can potentially prolong adenoviral infections and worsen HSV infections 1. Given the potential for severe dry eye syndrome to contribute to or exacerbate eye swelling, treatments such as autologous serum or plasma rich in growth factors drops, and in some cases, oral medications like cevimeline for patients with Sjögren’s syndrome, may be considered 1. However, the primary approach should always prioritize identifying and addressing the root cause of the swelling, with a focus on early detection and treatment to prevent complications and ensure the best outcomes in terms of morbidity, mortality, and quality of life 1.
From the FDA Drug Label
DOSAGE AND ADMINISTRATION: SHAKE WELL BEFORE USING. Two drops topically in the affected eye(s) four times daily. The treatment for a swollen eye may be prednisolone acetate ophthalmic suspension. The recommended dosage is two drops in the affected eye(s) four times daily 2.
- Key points:
- Use two drops in the affected eye(s)
- Use four times daily
- Concomitant use of anti-infective agents is mandatory in cases of bacterial infections. It is essential to follow the prescribed dosage and to not discontinue therapy prematurely. If signs and symptoms fail to improve after two days, the patient should be reevaluated.
From the Research
Treatment for a Swollen Eye
The treatment for a swollen eye depends on the underlying cause of the swelling. Some possible causes of a swollen eye include:
- Conjunctivitis (inflammation of the conjunctiva) 3, 4
- Allergic reactions 5
- Trauma or injury to the eye
- Infections such as blepharitis or keratitis 4
Treatment Options
Some treatment options for a swollen eye include:
- Topical corticosteroids to reduce inflammation 3, 6
- Topical antihistamines and mast cell stabilisers to treat allergic conjunctivitis 5
- Antibiotics to treat bacterial infections 3, 4
- Cold compresses or cryotherapy to reduce swelling 6
- Elevating the head to reduce fluid accumulation
When to Seek Medical Attention
It is essential to seek medical attention if the swelling is severe, or if there are other symptoms such as:
- Severe pain or vision loss 7, 4
- Increased sensitivity to light
- Discharge or pus from the eye
- Fever or chills
- Recent trauma or injury to the eye
In these cases, it is crucial to consult an ophthalmologist or other medical professional for proper diagnosis and treatment 7, 4.