Imagine descending to a beautiful reef. The water is clear, fish glide past, and then you feel a strange pull on your face, like the mask is trying to suction itself onto your eyes. When you surface your eyes are red, swollen, and possibly bruised. The cause was mask squeeze, a common but preventable dive injury.
Mask squeeze, also called facial barotrauma, happens when the pressure inside your mask doesn’t match the ambient pressure during descent. The water pressure rises as you go deeper, and if you don’t add a little air into the mask by gently exhaling through your nose, the trapped air stays at a lower pressure.
The mask presses inward and pulls on the soft tissues of the face. Small blood vessels around the eyes and eyelids can break, causing petechiae (tiny red spots) and bruising. The same effect on the eye’s surface can cause subconjunctival hemorrhages and mild swelling of the conjunctiva (the protective mucus membranes). It may look serious, but mask squeeze is rarely dangerous unless it affects your vision.
These eye injuries can take several days to settle. Just like any bruise, the color changes as the blood breaks down and your body reabsorbs it. It is typical for it to go from bright red to darker shades and then a greenish or yellow tint before returning to normal.
New divers are more prone to mask squeeze. Training dives involve learning to equalize the ears and sinuses, manage buoyancy, and maintain good position in the water. With so much happening, it’s easy to forget to add a little air to the mask.
Using poorly fitting rental masks or non-diving goggles, wearing masks too tightly, descending quickly, or diving with nasal congestion can also make it harder to exhale through the nose. A good mask should seal on the face without the strap.
Early signs are easy to catch. You might notice the mask starting to pull in as you descend. At the surface, you may see redness around the eyes or on the eyelids, bruising on the cheeks, or blood in the whites of the eyes. If there are vision changes, severe eye pain, major swelling, or any bleeding inside the eye, get medical evaluation right away.
Prevention is simple. Slowly exhaling through your nose during descent adds enough air to balance the pressure. Make sure your mask fits well and isn’t overtightened — extra tension does not improve the seal and can make equalizing harder. Take your time on the way down to equalize all air spaces. If you’re congested and can’t breathe easily through your nose, skip the dive.
If a mask squeeze happens, safely end the dive. Mild bruising or redness usually improves within a week or two. Cool compresses can help with swelling, and try to avoid rubbing your eyes. More serious symptoms, especially vision changes, need prompt evaluation by someone familiar with dive injuries.
Some medications increase the chances of bleeding. Aspirin and other blood-thinning drugs can make bruising or eye redness appear worse. Because aspirin is inexpensive and commonly sold over the counter in many countries, divers sometimes take it without realizing its effect on platelets. After a mask squeeze it’s best to avoid aspirin unless it’s medically necessary.
Mask squeeze is easy to prevent. Remember to equalize every air space, not only the ears and sinuses. If it keeps happening, revisit your equalization technique, slow your descent, and check your mask fit.
With a little awareness and preparation, mask squeeze is completely avoidable, leaving you free to enjoy the dive instead of dealing with an injury.
© Alert Diver – Q1 2026