Swelling of the damaged tissues behind the eyes can cause the eyes to become red and swelling to occur above and below the eyes. It may also cause the eyes to be pushed forward ('starey eyes', 'proptosis'). In more severe cases, the damage at the back of the eye causes swelling and stiffness of the muscles that move the eye, causing double vision. This occurs especially when looking from side to side as the muscles cannot keep the eyes exactly in line with each other. Occasionally, the swelling behind the eyes is severe enough to press on the nerve from the eyes to the brain affecting vision.
Other features that may occur include mild soreness and grittiness of the eyes usually only affecting one eye, increased watering of the eye, a dislike of bright lights and a feeling of discomfort behind the eyes especially when looking up or side to side. Puffiness of the upper eyelid or around the eyes giving the impression of baggy eyes is also common and is worse first thing in the morning. The eyes often appear 'starey' and drying of the eyes or too many tears can cause blurry vision which comes and goes.