You look up and one of your dog's eyes is not right. The lid is puffy, or the whole area looks fuller than the other side, and he keeps turning his head away from you.
A swollen eye in a dog covers a wide range, from an insect sting that settles in a day to pressure inside the eye that costs vision within hours. The tricky part is that they can look similar from across the room.
Your veterinarian is the right person for this, not a human eye doctor. What follows is meant to help you describe what you are seeing and judge how quickly you need to be seen.
Work out what is actually swollen
Different structures swell for different reasons, so start by getting a good look in decent light.
- The eyelids. Puffy, thickened, sometimes drooping. Common with allergic reactions, stings, infections of the lid margin and small lumps along the edge.
- The pink tissue around the eye. Angry red, sometimes bulging over the lid edge. This usually points to conjunctivitis or irritation.
- The eyeball itself. Looks bigger, or pushed forward so it sits further out than the other eye. This is a more serious sign.
- The third eyelid. Dogs have a membrane in the inner corner. If it is up across part of the eye, something is painful.
- Under or beside the eye. Swelling on the cheek below the eye often comes from a tooth root problem rather than the eye at all.
Note whether the surface of the eye is clear or cloudy, whether there is discharge and what color it is, whether the pupils are the same size, and whether he is squinting or holding the lid shut.
Common causes
Allergies and stings
Sudden puffiness of both lids, often with a swollen muzzle and scratching, suggests an allergic reaction. Bee and wasp stings do the same on one side. Most cases are mild, but reactions that involve breathing or collapse are emergencies.
Trauma and foreign material
A scratch from a branch, a claw during play, or a grass seed lodged under a lid. Dogs who run through undergrowth or hang out of car windows are the usual candidates. Anything stuck in the eye needs a vet, not tweezers at home.
Conjunctivitis
Redness, swelling and discharge from infection, irritants or allergies. It looks dramatic and is often straightforward, but it can also be the surface sign of something deeper.
Corneal scratches and ulcers
Damage to the clear front surface is intensely painful. You will usually see squinting, tearing, light avoidance and sometimes a dull or blue-gray patch. Ulcers can deepen fast. Flat-faced breeds are particularly prone, because their eyes are more exposed and they blink less completely.
Eyelid problems
Lids that roll inward push hair against the eye. Lids that roll outward leave it exposed. Extra lashes growing in the wrong direction rub with every blink. All cause chronic irritation and swelling, and all are structural problems needing veterinary assessment.
Inflammation inside the eye
Uveitis is inflammation within the eye, often linked to infection or wider illness. It brings pain, redness, cloudiness and a small pupil, and it needs prompt treatment.
Glaucoma
Pressure inside the eye rises and the globe enlarges. A cloudy, hard, painful eye with a dilated pupil that does not respond to light is a true emergency. Vision can be lost in a day, and some breeds are predisposed.
Signs that mean same-day care
Call your vet immediately, and ask for an emergency appointment, if you see any of these.
- The eye is held shut, or he flinches when the area is touched
- The surface is cloudy, blue-gray, or has a visible dent or crater
- The eyeball looks enlarged or is protruding
- The pupils are different sizes, or one does not react to light
- Bleeding, or thick yellow or green discharge
- He is bumping into things or hesitant on stairs
- Anything is stuck in or on the eye
- The swelling followed a blow, a fight or a chemical splash
- He is rubbing the eye persistently on furniture or with a paw
- Swelling came on within an hour, especially with a puffy face
Slower, milder swelling in a comfortable, bright dog who eats normally can usually wait for a regular appointment. If it has not improved within a day, or worsens at any point, go in.
What to do, and not do, before the appointment
- Stop the rubbing. A recovery cone prevents a scratch becoming an ulcer in an afternoon.
- Wipe discharge from around the eye with a clean, damp cloth, working outward, and use a fresh area for each pass.
- Do not use human eye drops. Redness relief drops and anything containing a steroid can seriously worsen a corneal ulcer.
- Do not reuse leftover medication from a previous problem or from another pet.
- Do not force the lids open or try to remove anything yourself.
- Take a photo in good light. Swelling changes, and it helps to show what it looked like at its worst.
What the vet will do
Expect an examination of both eyes with magnification, a stain that reveals scratches or ulcers on the surface, a check of the tear production, and a measurement of the pressure inside the eye. Those three tests separate most of the causes above from each other quickly.
Treatment depends entirely on the finding, which is why the diagnosis comes first. Some cases resolve with medication in days. Others need a veterinary eye specialist. Keep the follow-up appointment, because corneal problems can look better while still being incompletely healed.
Common questions
Can I use a saline rinse or a cold compress?
Plain sterile saline is generally safe for gently flushing debris, and a cool compress can ease lid puffiness. Neither treats an underlying cause, and neither should delay a call if the eye looks painful.
Why does one breed seem to get this more?
Face shape matters. Flat-faced dogs have shallower sockets and more exposed corneas. Breeds with loose facial skin are prone to lid problems. Some lines are predisposed to glaucoma.
How do I know if he is in pain?
Dogs hide it. Squinting, a raised third eyelid, tearing, keeping the head turned away, and going unusually quiet are all pain signals.
When in doubt, phone your veterinary practice and describe what you are seeing. They would far rather triage a swollen lid that turns out to be a sting than see an ulcer two days late. And while you are thinking about eyes, it may be a good moment to check whether your own eye exam is overdue.