Puffy Eyes

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What are puffy eyes?

Puffy eyes are a common symptom of allergy, infection, inflammation, or even physical irritation. Puffy eyes result from excess fluid (edema) in the soft tissues surrounding the eyes. The medical term for puffy eyes is chemosis. Puffy eyes may occur in conditions affecting the eye area itself or in association with more generalized conditions, such as colds or hay fever.

Inflammation of the surface of the eye (conjunctivitis) and inflammation of the eyelids (blepharitis) are common causes of puffy eyes. Other common causes include crying, lack of sleep, or excessive rubbing of the eyes. Depending on the cause, one or both eyes may be puffy, and the puffiness may be accompanied by redness, pain, itching, excessive tear production, or other types of discharge from the affected eyes.

Allergic reactions can lead to puffiness of both eyes, sometimes accompanied by swelling of the whole face in severe cases such as anaphylactic reactions. In rare cases, puffy eyes are a symptom of serious infections of the soft tissues around or behind the eye, such as orbital cellulitis. The thyroid condition known as Graves’ disease may be accompanied by swelling of the conjunctiva in addition to bulging eyes (proptosis). Injuries or trauma to the eyes, including corneal abrasions, orbital bone fracture, and foreign bodies in the eye, can all cause puffy eyes.

Puffy eyes may bea sign of a serious condition. Seek immediate medical care (call 911) if you experience puffy eyes along with facial swelling, difficulty breathing, or fever. Other symptoms that require immediate medical care include puffy eyes along with eye pain, fever, chills, pus, or redness around the eye. These are symptoms of orbital cellulitis. Untreated, they can rapidly lead to serious complications such as meningitis or a blood infection.

Seek prompt medical careif your puffy eyes are persistent or cause you concern.

What other symptoms might occur with puffy eyes?

Puffy eyes may accompany other symptoms, which vary depending on the underlying disease, disorder or condition. Puffy eyes may also involve other body systems.

Ocular symptoms that may occur along with puffy eyes

Puffy eyes may accompany other symptoms related to the eye including:

  • Discharge from the eyes
  • Dry eyes
  • Excessive tear production
  • Increased sensitivity to light
  • Itchy eyes
  • Lumps or nodules of the eyelid or skin
  • Red, sore eyes (bloodshot eyes)

Other symptoms that may occur along with puffy eyes

Puffy eyes may accompany nasal symptoms such as:

Serious symptoms that might indicate a life-threatening condition

In some cases, puffy eyes may occur with other symptoms that might indicate a serious or life-threatening condition. Seek immediate medical care (call 911) if you, or someone you are with, have puffy eyes along with other serious symptoms including:

  • Bleeding from the eye

  • High fever (higher than 101 degrees Fahrenheit)

  • Protruding or bulging eye(s) (proptosis) with redness, fever and pain

  • Respiratory or breathing problems, such as shortness of breath, difficulty breathing, labored breathing, wheezing, not breathing, or choking

  • Sudden change in vision, loss of vision, or eye pain

  • Sudden swelling of the face, lips, throat or tongue

What causes puffy eyes?

Puffy eyes result from excess fluid in the soft tissues surrounding the eye. Common causes include crying, lack of sleep, or excessive rubbing of the eyes. Allergic reactions also frequently cause puffy eyes. These allergic reactions may be caused by pollen (hay fever), animal dander, foods, or medicines. Personal care products such as make-up, moisturizers, shampoo and soap can cause reactions leading to puffy eyes. Irritation from environmental factors such as smoke, smog or dust can result in puffy eyes. The same irritant may also cause significant swelling of the eyelids skin.

Infections that cause inflammation of the eyelids or the conjunctiva (surface) of the eye are also common causes of puffy eyes. Infections may occur in one or both eyes and may be caused by viruses or bacteria. The condition often called pink eye is a contagious form of conjunctivitis caused by a viral infection. Orbital cellulitis, a serious infection of the skin around the eyes can also cause puffy eyes.

Graves’ disease and other forms of thyroid disorders can cause puffy eyes. Puffy eyes can also result from an injury of the bones or tissues around or in the eyes.

Allergic causes of puffy eyes

Allergic reactions are a common cause of puffy eyes. Examples include:

  • Allergic reactions to medications such as penicillin or codeine

  • Food allergies (allergic reaction to certain foods)

  • Hay fever or allergic reaction to animal dander, dust, cosmetics, or pollen

  • Insect bite allergy such as to a bee sting

Inflammatory causes of puffy eyes

Infections or irritation can cause inflammation leading to puffy eyes such as:

  • Bacterial infection

  • Blepharitis (inflammation of the eyelid margin)

  • Chalazion (inflammation of a blocked oil gland in the eyelid margin)

  • Conjunctivitis (inflammation of the eye surface)

  • Corneal abrasion or ulcer

  • Periorbital cellulitis (an infection of the eyelids or other soft tissue around the eyes)

  • Sinusitis (an inflammation or infection of the sinuses)

  • Stye or hordeolum (a localized bacterial infection of an oil gland or eyelash follicle in the eyelid margin)

  • Viral infection

Chemical causes of puffy eyes

Puffy eyes can also be caused by exposure to chemical irritants such as:

  • Household cleaning solvents

  • Personal care products such as makeup, moisturizers, shampoo and soap

  • Swimming pool chlorine

Serious or life-threatening causes of puffy eyes

In some cases, puffy eyes may be a symptom of a serious or life-threatening condition that should be immediately evaluated in an emergency setting. These conditions include:

  • Anaphylaxis (life-threatening allergic reaction)
  • Fracture of the bony orbit
  • Ocular trauma
  • Orbital cellulitis (invasive infection of the soft tissues around the eye)

    Questions for diagnosing the cause of puffy eyes

    To diagnose your condition, your doctor or licensed health care practitioner will ask you several questions related to your puffy eyes including:

    • When did you first notice your puffy eyes?

    • Are you experiencing any sensitivity to light?

    • Do you have any other symptoms involving your eyes?

    • Have you had any changes in your vision along with your puffy eyes?

    • Do you have other symptoms such as a stuffy nose or postnasal drip?

    What are the potential complications of puffy eyes?

    If your eyes are regularly puffy eyes, it could indicate that you have an eye allergy, eye infection, or stye. Some infections and inflammatory conditions associated with puffy eyes can be serious. Once the underlying cause is diagnosed, it is important for you to follow the treatment plan that you and your health care professional design specifically for you to reduce the risk of potential complications including:

    • Cellulitis (infection of the skin and underlying tissues)

    • Encephalitis (inflammation and swelling of the brain due to a viral infection or other causes)

    • Loss of vision or changes in vision

    • Tissue scarring and restricted eye mobility

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    Medical Reviewer: William C. Lloyd III, MD, FACS
    Last Review Date: 2021 Jan 3
    1. Eye problems. FamilyDoctor.org. http://familydoctor.org/familydoctor/en/health-tools/search-by-symptom/eye-problems.html.
    2. Graves disease. Medline Plus, a service of the National Library of Medicine National Institutes of Health. http://www.nlm.nih.gov/medlineplus/ency/article/000358.htm.
    3. Pokhrel PK, Loftus SA. Ocular emergencies. Am Fam Physician 2007; 76:829
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