What is eyelid swelling?
Eyelid swelling is the enlargement of either or both the lower and upper eyelids, on one or both eyes. It is due to fluid buildup or inflammation in the delicate tissues surrounding the eye. Swollen eyelids due to fluid buildup or ‘retention’ may also be referred to as puffy eyes or puffy eyelids. It usually would involve both eyelids. Swelling due to inflammation may be localized to a small area or the entire eyelid.
A variety of mild to serious diseases, disorders and conditions can lead to eyelid swelling. Swelling can result from harmless causes like crying or rubbing, or from more serious conditions like infections, trauma and cancer. The most common cause of eyelid swelling is allergies, either by direct contact with the allergen (such as animal dander entering your eye) or from a systemic allergic reaction (such as a food allergy or hay fever). If one eyelid is swollen, a common cause is a chalazion, an obstructed gland along the rim of an eyelid.
Depending on the cause, eyelid swelling can last for a short time and disappear quickly, such as when you have a mild allergic reaction to animal dander or dust. Eyelid swelling that develops over time and occurs along with additional symptoms may be a sign of a more serious condition that affects the entire body, such as hyperthyroidism (Graves’ disease) or infection.
Eyelid swelling from infection can arise from infection of the eyelid itself, triggered by an infected wound, chalazion, or pink eye. Spread of infection to the eye area from somewhere else, such as the nasal or sinus cavities can also cause eyelid swelling. Infection involving the eye and surrounding tissues is very serious and requires antibiotics to clear the bacteria and preserve the eye.
Because eyelid swelling and swelling in general (edema) may be a sign of a serious condition, you should talk with your medical professional about your symptoms. If you experience eyelid swelling accompanied by fever, vision problems (like blurry vision), abnormal eye movements (or loss of movement), protrusion (bulging) of the eye, or signs of anaphylactic shock (swollen tongue and throat, hives, and difficulty breathing), seek immediate medical care (call 911).
What other symptoms might occur with eyelid swelling?
Eyelid swelling may occur with other symptoms depending on the underlying disease, disorder or condition. For example, eyelid swelling due to a blocked oil gland (chalazion) may not be accompanied by any other symptoms; whereas, eyelid swelling due to a mild allergic reaction can be accompanied by sneezing and watery, itchy eyes.
Eyelid swelling happen often after facial injuries or surgery, even if the eyelids were not involved. For example, a broken nose may result in bruised and puffy eyelids.
You may experience problems with the eye itself, or you may have symptoms that affect other body systems, such as the immune system. Eyelid swelling along with bulging of the eyes and a myriad of other symptoms, such as increased appetite, heat intolerance, and fatigue, can indicate an autoimmune disorder called Graves’ disease. Eyelid swelling due to general edema (swelling) can be accompanied by facial and possibly leg swelling. Swelling due to infection may include redness, fever, pain and possibly difficulty moving the eyeball.
Vision and other eye-related symptoms that may occur along with eyelid swelling
Eyelid swelling may accompany vision problems and other eye symptoms including:
- Bleeding from the eye
- Discharge from the eye
- Drooping eyelid
- Dry eyes
- Inability to turn the eyeball
- Increased sensitivity to light
- Increased tear production (watery eyes)
- Protruding or bulging eye(s) (proptosis)
- Red, itchy eyes
- Skin sores or pus-filled bump
Other symptoms that may occur along with eyelid swelling
Eyelid swelling may accompany other abnormal signs and symptoms including:
- Difficulty concentrating
- High blood pressure
- Symptoms of sinusitis (facial pain and swelling)
- Symptoms of Graves’ disease (anxiety, irritability, heat intolerance, unexplained weight loss, difficulty concentrating, and goiter)
Serious symptoms that might indicate a life-threatening condition
In some cases, eyelid swelling can indicate a serious or life-threatening condition that should be immediately evaluated in an emergency setting. Seek immediate medical care (call 911) if you, or someone you are with, have any of these life-threatening symptoms including:
- Acute loss of vision
- Eyelid swelling after head trauma
- Feeling like your throat is tight
- General edema (swelling)
- High fever (higher than 101 degrees Fahrenheit) with red and tender areas
- Itching in the throat or mouth
- Neck stiffness
- Protruding or bulging eye(s) (proptosis) with redness, fever and pain
- Severe headache
- Swollen tongue
- Wheezing or difficulty breathing
What causes eyelid swelling?
Although eyelid swelling can be due to relatively mild conditions, such as a blocked oil gland, swelling can also be caused by serious or life-threatening conditions, such as anaphylactic shock, that should be immediately evaluated in an emergency setting.
Common causes of eyelid swelling
- Allergies and allergic reactions: Seasonal allergies like hay fever, as well as allergic reactions to food, drugs, and bee stings can cause swelling of both eyelids. If one eye is swollen, red and itchy, it is usually from an allergic reaction to something directly in your eye, such as animal dander or dust. An antihistamine is oftentimes the only treatment necessary, along with rinsing the eye with over-the-counter artificial tears (sterile saline solution) and applying cool compresses. For severe eyelid swelling; swelling of the face, lips or tongue; and difficulty breathing, get immediate medical help or call 911. See an allergist for recurrent eyelid swelling due to allergies.
- Chalazion: A chalazion is an obstructed gland that can occur along the inside rim of the upper or lower eyelid. People with rosacea have an increased risk of developing chalazions. Swelling is usually localized but it can involve the entire eyelid, blocking eyesight. The swelling is usually not painful. To help clear the gland and its contents, hold a warm washcloth over the swollen eyelid several times a day. It can take several weeks for the gland to clear and swelling to subside.
- Stye: The medical term for stye is hordeolum, swelling due to inflammation or a Staphylococcal infection of an eyelash follicle. There is usually pus at the center of the swollen eyelid with a stye, and it is red and painful to touch. A stye may rupture within a few days, which releases the pus and reduces swelling. A healthcare provider can prescribe prescription antibiotic drops if necessary.
- Blepharitis: Signs and symptoms of blepharitis including eye redness, burning, itching and swelling of the eyelids. It can occur in one or both eyes. Blepharitis can start with a stye or occur alone. An eye doctor diagnoses blepharitis and treats it with corticosteroids and antibiotic eye drops. At-home remedies include warm compresses several times a day.
- Conjunctivitis (pink eye): This is a bacterial or viral infection of the conjunctiva, the thin tissue lining your eyelids and covering the white part of your eye. Symptoms include swelling, eye redness and itchiness, tears, and eye discharge. It can occur in one or both eyes. Allergies can also inflame the conjunctiva. Infectious conjunctivitis is very contagious and requires professional medical treatment.
- Cellulitis and orbital cellulitis: Infection of the eyelid(s) and surrounding skin is periorbital cellulitis, often from conjunctivitis, chalazion, stye or sinusitis. Infection of the orbit, or socket is orbital cellulitis, which can start from the sinus cavities and other areas of the face. Vision problems are more likely with orbital cellulitis. Infection involving the eye orbit and surrounding tissues is very serious and requires antibiotics to clear the bacteria and preserve the eye and other facial structures.
- Trauma: Skull fractures, burns, direct blows, foreign objects in the eye, and surgery can cause eyelid swelling, often with discoloration. Eyelid swelling after trauma should always be evaluated in an acute care clinic. Also, after a medical procedure, a doctor should investigate eyelid swelling beyond what is anticipated. For example, eyelid swelling is expected after any type of facial surgery.
Other causes of eyelid swelling
Eyelid swelling can be due to a variety of infections including:
- Sinus infection or sinusitis
Eyelid swelling can be a symptom of various other conditions including:
- Fluid retention (edema), such as during pregnancy
- Hereditary angioedema
- Hyperthyroidism (Graves’ disease)
- Kidney disease
- Organ failure, such as heart, liver or kidney failure, all of which can cause edema
How can you prevent eyelid swelling?
Preventing eyelid swelling depends on the cause.
- Allergies: For the most common cause of swollen eyelids—allergies—taking allergy medicine daily will help prevent symptoms. Do not rub your eyes; that will make swelling more likely. If eyelid swelling happens frequently, consider allergy testing to determine what you are allergic to. Once you identify the exact allergens, you can avoid them. Use hypoallergenic facial and makeup products. If you use eye drops for occasional redness and your eyes and eyelids become irritated, use preservative-free eye drops, as the preservative can irritate the eyes. You can purchase single-use artificial tears. Also, some people are allergic to contact lens material, especially silicone-containing lenses. Talk with your optometrist if you think your contacts may be the culprit.
- Infectious causes: Cleaning your eyelids twice a day with a mild cleanser (try baby shampoo mixed with water) can help prevent eyelid infections and swelling. If you wear eye makeup, do not share it with anyone. Treating eyelid conditions with at-home treatments and any medicines your doctor prescribes will help minimize eyelid swelling.
- Fluid retention: For causes related to edema, you can help prevent eyelid swelling by drinking plenty of water and consuming a low-salt diet as directed by your physician. Alcohol use can increase edema, so cutting back on consumption may help prevent swelling. Treating the underlying condition, such as kidney disease, may help control the swelling. Sleeping with your head elevated will help excess fluids drain away from your delicate eye tissue, reducing the appearance of puffy eyes when you wake up.
How is eyelid swelling treated?
You can treat most cases of eyelid swelling with simple at-home remedies, such as cool compresses for occasional eye redness and swelling. However, you should see a doctor promptly for chronic, or suddenly or severely swollen eyelids, especially if you are experiencing other symptoms or there are changes in your vision.
In most cases, treating the underlying cause of eyelid swelling will help resolve swelling. See an ophthalmologist for an accurate diagnosis or for referral to a specialist who can address the primary cause.
Medical treatments may include:
- Allergy treatment, including allergy shots and prescription allergy medicine
- Antibiotic eye drops or oral antibiotics for bacterial infections
- Antiviral eye drops or ointments in case of herpes or shingles
- Corticosteroids or other types of anti-inflammatory eye drops
- Incision and drainage of a stye, chalazion or abscess
- Medication and other therapies to treat the underlying condition causing swelling, such as thyroid hormone for hypothyroidism and diuretics for heart failure
- Removal of foreign object in the eye or eyelid
Eyelid swelling at-home treatments
For mild eyelid swelling, here are some remedies you can try at home:
- Wash and rinse the skin around your eyelids (baby shampoo mixed with water works well, or you can purchase eyelid ‘scrub’ pads); gently pat dry.
- Use sterile saline or artificial tears to rinse your eyes.
- Apply cool compresses, including cold (caffeinated) tea bags. Caffeine constricts the tiny blood vessels in your eyes and eyelids, which helps reduce fluid leakage and puffy eyelids (edema).
- Rest and sleep with your head elevated. This will help drain fluids away from your eyelids and surrounding tissues.
- Do not wear contact lenses until your eyelid swelling goes away. It’s possible to have an allergy to the contact lens material, so consider that possibility if swelling resolves when you are not wearing the lenses.
For styes and chalazia, use hot compresses for 5 to 10 minutes a few times a day, along with medicine your doctor prescribes for infection or inflammation.
How to treat eyelid swelling from allergies
- Take an antihistamine or another type of allergy medicine.
- Gently rinse your eye and surrounding area with sterile saline (preservative-free, single-use containers).
- Apply cool compresses and rest with your head elevated.
For eyelid swelling associated with severe allergic reactions, contact a healthcare professional right away. The self-care measures still help reduce swelling, but you may need a shot of epinephrine at the doctor’s office or emergency department to calm the reaction.
How long does it take to reduce eyelid swelling?
For temporary causes, such as allergies, it may take as little as a few hours to reduce eyelid swelling with home remedies and an antihistamine.
For minor infections and blocked glands, expect 1 to 3 weeks for localized eyelid swelling to go down with proper treatment. It may take longer to reduce eyelid swelling from cellulitis and orbital cellulitis, especially if the infection does not respond well to antibiotics and additional treatment is necessary.
For general edema and ‘puffy’ eyes, how long it takes to reduce eyelid swelling depends on the diagnosis and treatment. Temporary fluid retention from eating a salty meal, for instance, may resolve within 24 hours with at-home treatment (increasing water intake and reducing salt).
For more serious causes of eyelid swelling, such as organ failure, preeclampsia, or thyroid disorders, swelling may not resolve until the root problem is treated.
When should you see a doctor for eyelid swelling?
In some cases, eyelid swelling is a symptom of a serious condition that should be immediately evaluated by a medical professional. Seek immediate medical care (call 911) if you experience any of these life-threatening symptoms including:
- Acute (sudden) loss of vision
- Eyelid swelling after head trauma
- Anaphylaxis symptoms, which may include swollen tongue, lips or mouth; itching; and wheezing or feeling like your throat is tight
- General edema (swelling) throughout the body, which may be noticeable in your feet and ankles too
- High fever (higher than 101 degrees Fahrenheit) with red and tender areas
- Neck stiffness
- Protruding or bulging eye(s) (proptosis) with redness, fever and pain, as these are signs of infection in the eye socket (orbit)
- Severe headache
Questions for diagnosing the cause of eyelid swelling
To diagnose the underlying cause of eyelid swelling, your primary care or eye doctor may ask you several questions related to your symptoms:
- Describe the swelling. When did the swelling start? Does it come and go or is it constant?
- Did you eat any foods or come in contact with any unusual substances preceding the swelling?
- Are you experiencing any pain, shortness of breath, or other symptoms?
- Are any other areas swollen?
- How does the eyeball itself look? (normal, red, inflamed, protruding)
- Provide your full medical history, including all medical conditions, surgeries and treatments, family history, and a complete list of the medications and dietary supplements that you take.
What are the potential complications of eyelid swelling?
Complications associated with eyelid swelling can be progressive and vary depending on the underlying cause. Because eyelid swelling can be due to serious diseases, failure to seek treatment can result in complications and permanent damage. It is important to visit your healthcare provider when you experience any kind of persistent swelling or other unusual eye symptoms. Once the underlying cause is diagnosed, following the treatment plan outlined by your doctor can help reduce any potential complications including:
- Chronic discomfort or pain
- Loss of sight (blindness)
- Loss of the eye and orbit (structures surrounding the eye globe)
- Spread of infection to other parts of the body, including the brain and blood-borne spread