Red Eyes and Bulimia: Why it Happens

By Daniela Grayeb, MD, FACP, CEDS

Red Eyes and Bulimia

Why Some Patients with Bulimia Develop Red Eyes

Bulimia nervosa is a disorder that consists of episodic binges (large amounts of food and drink ingested in a brief period) followed by self‐deprecating thoughts and a fear of gaining weight. This eating disorder results in behaviors intended to rid the body of the effects of the binge, including fasting or exercising (non-purging subtype), vomiting, laxative, or diuretic use (purging subtype).

In rare cases, patients with bulimia might have broken blood vessels in the eye (subconjunctival hemorrhage) related to repeated episodes of forceful vomiting. When purging, there is an acute increase in pressure in the eye that can cause the blood vessels to rupture, causing the white of the eye to appear bright red.

Self-induced vomiting can also cause periorbital petechiae (small red dots around the eye). Like rupturing the blood vessels within the eyes, purging can also cause the capillaries (tiny blood vessels) around the eyes to break, causing a red speckled appearance.


Red Eyes and Dehydration

Dry eyes are another common complaint by those with eating disorders. Self-induced vomiting, laxative and diuretics abuse, and fasting can all cause dehydration, making the eyes dry and irritated. Dry eyes maybe exacerbate redness if the patient is frequently touching or rubbing their eyes.


Do Bulimia-related Red Eyes Affect Vision?

Fortunately, retching-induced red eyes and redness around the eyes have no impact on vision.


Are Red Eyes a Sign of a Life-threatening Bulimia Complication?

While red eyes due to bulimia are rare, it is neither life-threatening nor a sign of any life-threatening complication.


Treatment Methods and Recovery Time for Red Eyes

Red Eye Treatment & Recovery Timeline

There is no specific treatment for red eyes. Red eyes typically resolve with time. Subconjunctival hemorrhage typically resolves within two weeks. However, if purging has not ceased, red eyes may reoccur or persist beyond this period. Periorbital petechiae typically resolve shortly after vomiting.


Other Physical Manifestations of Bulimia

Chipmunk Cheeks (Sialadenosis)

One of the ubiquitous signs of bulimia is what’s known as sialadenosis, or “chipmunk cheeks.” Chipmunk cheeks are caused due to the enlargement of the parotid gland, one of three of the human body’s salivary glands. The cause of sialadenosis is unknown but could be connected to purging, binge eating or another unknown reason.

Calloused Knuckles

Calloused knuckles, or Russel’s sign, is another common indicator of bulimia. Calloused knuckles occur due to pushing the fingers into the mouth, causing irritation and abrasions on the back of the hand.

Erosion of Dental Enamel

Another common sign of bulimia is the erosion of the dental enamel, which is most noticeable in patients who self-induce vomiting and is most notable on the lingual surface (part of the tooth facing your tongue) of the upper teeth.


Get Help for Bulimia

If you or someone you care about is experiencing severe medical complications due to bulimia, ACUTE can help. Bulimia can cause a wide variety of medical complications, some life-threatening. Contact to us today to learn more about medical intervention for severe and extreme eating disorders with our experts at ACUTE. With proper care provided by experienced experts, we can help you restore your weight and regain your health.



  • Mehler, P. S., & Andersen, A. E. (2017, November 29). Eating Disorders: A Guide to Medical Care and Complications (third edition). Johns Hopkins University Press.

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In 2018, the ACUTE Center for Eating Disorders & Severe Malnutrition at Denver Health was honored by Anthem Health as a Center of Excellence for Medical Treatment of Severe and Extreme Eating Disorders. ACUTE is the first medical unit ever to achieve this designation in the field of eating disorders. It comes after a rigorous review process.

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