When either the lower or upper eyelid (or both) becomes enlarged it is referred to as eyelid swelling. A swollen eyelid is due to a buildup of fluid within the thin layers of tissue surrounding the eye. Swollen eyelids are sometimes referred to as puffy eyelids.
A swollen eyelid can be difficult to deal with at times. Unfortunately, most of us have had to deal with a swollen eyelid at some point in our lives. Puffy, swollen eyelids can cause discomfort, embarrassment, impaired vision, and difficulty applying cleanser or make-up.
Eyelid swelling can become serious if it is not treated properly and quickly. In most cases, puffiness, tenderness, and red swelling of your upper and/or lower eyelid are indications of infection. Sometimes the swelling can be accompanied by discharge in the corner of your eye.
Depending on the severity of your swelling, and depending on whether it is painful, you may want to seek medical attention immediately. You can try at-home remedies, but if you have a swollen eyelid and you do not know what the underlying cause is, you need to find out in order to prevent the condition from recurring or persisting.
What Causes a Swollen Eyelid?
Swollen eyelids can be caused by:
- Infections: Bacterial or viral infections can often cause swollen eyelids. These kinds of infections can be caused by improperly stored or misused cosmetics (or by sharing cosmetic eye makeup with a friend), or by rubbing your eyes when your hands are dirty, or by any number of other practices. If your swollen eyelids do not go away within a few days, or if they are accompanied by eye discharge, it is quite possible that you are suffering from a bacterial infection and need to seek medical attention. Your eye doctor can prescribe an antibiotic to treat your infection.
- Conjunctivitis: This condition, also known as pink eye, causes the protective membrane lining the eyelids and conjunctiva (the exposed region of the eyeball, aka the white of your eye) to become swollen, itchy, and red. Pink eye can also cause your eyelids to swell. This condition has a variety of causes, ranging from bacterial infection to allergies; if it persists, see your eye doctor.
- Orbital Cellulitis: This is a rare condition involving an infection of the tissues surrounding the eyes. If orbital cellulitis is left untreated, it can spread to the sinuses and even further. Cellulitis infection requires immediate medical intervention. If you have a fever, or your eye is hot to the touch, or if you are experiencing eye discharge, call your doctor at once. If your doctor cannot see you right away, go to an urgent-care clinic, or to the emergency room.
- Blepharitis: This inflammation of the eye margin is usually caused by a bacterial infection or a skin disorder. In either case, the eyelash follicles become inflamed and painful, and the affected person may notice discharge from the eye, pain, swelling, blurred vision, and a gritty sensation when blinking.
- Styes: A stye (also called a hordeolum) is a kind of eyelid cyst caused by a bacterial infection in the sweat- or oil-producing glands at the base of the eyelashes. A stye may be accompanied by pus, swelling, and redness. Styes usually go away on their own within a few weeks, and the healing process can be speeded along by applying a warm, wet compress to the affected eye each day for fifteen minutes.
- Chalazion: A chalazion resembles a stye. It appears as a small, firm, round nodule the eyelid, and it is caused by eye-duct blockage in the eye’s lubricating glands. Chronic blepharitis sufferers are somewhat prone to chalazia. Like a stye, a chalazion will often go away on its own, although in some cases surgery will be necessary to remove it.
- Eyelid Dermatitis: This condition produces wrinkled, swollen, red, itchy, sometimes scaly eyelids. It is caused by an allergic reaction.
- Blepharochalasis: This is an eye disorder, usually affecting children, that causes inflammation and swelling of the eyelids.
- Shingles: This condition is caused by the Herpes Zoster (chickenpox) Virus. It manifests itself as a painful, itchy rash, sometimes accompanied by fluid-filled blisters. Other symptoms include fever, photophobia (sensitivity to light), and fatigue. If you have had chickenpox as a child, the virus lies dormant in your body, and at some point later in life it is possible for it to reactivate itself, resulting in shingles. Fortunately, shingles more often affects the torso than the eyes.
- Eye Allergies. When we are exposed to a substance to which we have an allergy, the body produces histamines, which cause a number of unpleasant symptoms, including eyelid swelling.
- Gland Blockage, resulting from an infection or overproduction of fluids within the eye.
- Contact lenses or solutions: Dirty lenses or certain types of cleaning solutions can contribute to swollen eyelids. Dirt—even microscopic particles—on the lens can irritate the eye and the skin underneath the eyelid, causing swelling and puffiness. Cleaning solutions can also cause irritation; although they are formulated to be safe for use in the eye, a small number of contact lens wearers fins that they are allergic to cleaning solutions. If this is the case for you, ask your doctor what alternatives may exist that would work for you.
Puffy, swollen eyelids can also be caused by:
- Lack of sleep
- Too much sodium in the diet: the body needs to maintain a proper balance of salt and water; therefore, excessive salt consumption causes the body to react by retaining fluid, which results in swelling in certain places all over the body, including the eyelids.
- Too much alcohol
- Crying—this actually causes eyelid swelling in a similar way to excess sodium intake: the salt in your tears causes the surrounding tissue to swell with water.
- Too much artificial sweetener in diet
- Genetics: many people are simply born with a predisposition to swollen eyelids.
- High blood pressure: this can cause the blood vessels in the eyes to expand and swell, making the skin appear puffy.
- Hormonal imbalances of the sort that accompany pregnancy
- Certain medications can cause tissue swelling all over the body. Often water retention is the culprit.
Anyone experiencing a single, sudden, unexplained swollen eyelid should seek medical attention from an eye specialist.
If you are experiencing eyelid swelling on a regular basis it could be due to an allergic reaction to your face wash, fragrances, make-up, or laundry detergent. If you have no known allergies, there could be a more serious problem or eye condition causing the swelling.
Swollen Eyelid Symptoms
Swollen eyelids are usually accompanied by other symptoms. These symptoms can occur before or after the swelling begins. Additional symptoms may include:
- Scale formation
- Difficulty blinking
- Inability to open or close eye completely
- Facial swelling
- Loss of eyelashes
These symptoms can sometimes be just as annoying as the swollen eyelid itself. It is extremely important that you avoid touching or rubbing your eye and eyelid at all times. You can introduce foreign objects or other bacteria into your eye by doing so, which will only make the symptoms worse. If you are experiencing any of these symptoms, or if your puffy eyelids are severe, then you should contact your doctor immediately.
Swollen Eyelid Treatment
Again, depending on the severity and cause of your swollen eyelid, you may want to seek medical attention. However, if you feel confident that you know the cause, and if your swollen eyelids are a normal, familiar (if unwelcome) condition then there is probably no need to seek medical attention as long as your condition does not persist for significantly longer than it normally does. Some people are sufficiently in tune with their bodies to know the exact cause of the swelling, especially if it is allergy-related. For others, however, the swelling can come as a surprise.
The first thing you should do, regardless of the cause of your swollen eyelid, is avoid touching, rubbing, or staring at the swelling. Staring at the swollen eyelid will only lead to touching and rubbing, so stay away from the mirror in order to avoid the temptation.
Avoid wearing make-up, including powders and base. Powders are made up of particles that can drift through the air and irritate your eyelids even more.
Try putting a cold, damp cloth on your swollen eyelid(s) twice a day. Splashing cool water on your face can help reduce facial swelling.
Over-the-counter antihistamines or eye drops can help too. A few years ago, Allegra began selling their prescription-strength product over the counter, making it available to everyone without the necessity of seeing a doctor.
If you choose to seek medical attention, your doctor may prescribe you a prescription-strength antihistamine, special eye drops, or an ointment to treat the swelling. Your doctor will also be able to determine whether there is an infection and prescribe you antibiotics if he or she deems it necessary.
Common at-home remedies for eyelid swelling include:
- Anti-inflammatory creams: Some people recommend products such as Preparation H to reduce swelling around the eyes, but this practice is rooted in urban legend. There is no medical evidence that it works, and the Whitehall-Robins company, which makes Preparation H, has stated publically that they do not recommend using their product for this purpose.
- Cold water: splashing cold water on your skin causes the blood vessels to constrict in order to reduce heat loss—thereby reducing swelling. A cold, wet cloth, an ice pack, or a bag of frozen peas can serve the same purpose.
- Gently tapping your puffy eyelids, which helps release and drain built-up fluid
- Drinking more water: if dehydration is the cause of your swollen eyelids, drinking more water will get your body out of fluid-retention mode, which should cause the swelling to go down.
- Avoiding artificial sweeteners: some studies indicate that artificial sweeteners may interfere with kidney function and cause swelling (among other, more serious problems)
- Avoid salt
- Get more sleep
- Consume more fatty acids like flax seed or fatty fish: omega-3 fatty acids can act as anti-inflammatory agents, and may also assist with the functioning of the glands that lubricate the eyes.
Eyelid Swelling in Children
Like adults, children can be affected by swelling in their eyelids. Common causes include trauma and allergies, but a child, like an adult can also develop a swollen eyelid from an eye condition such as blepharitis and pink eye (conjunctivitis), which we described earlier in this article.
Children also experience symptoms like redness, burning sensations, watery eyes, and pain. If a child is constantly rubbing his or her eyes, it may be a sign that the child is suffering from an eye condition of some sort.
As with adults, treatment options for children vary based on the cause of the puffy eyelids. Children can often be given the same types of treatments that work for adults. Depending on the cause, treatment may include:
- Eye drops
Never give a child over-the-counter medications to treat eyelid swelling without first consulting their healthcare provider, pediatrician, or eye-care specialist.
It is important to note that orbital cellulitis is more common in children than in adults, and that it is an emergency that needs to be treated, often with admission to a hospital and IV antibiotics. If a child has an acutely swollen painful eyelid that is hot to the touch, especially if accompanied by fever, go immediately to your local emergency room.
Complications of a Swollen Eyelid
For some people the swelling may be minor and may not produce any noticeable complications. Others may experience such common complications as:
- Difficulty seeing
- Difficulty putting on make-up
- Difficulty washing face
- Difficulty performing normal tasks such as reading or driving
- Treatment options may not be effective
- Eye infection
It is impossible in the context of an article like this one to comprehensively address a subject like complications; too much depends on the cause and nature of the problem. Certainly, more severe complications are apt to arise from, for example, a cellulitis infection than from an attack of allergic conjunctivitis on a day when there is a high atmospheric pollen count.
All that is to say that no one is a better judge of the potential severity of your condition than you are, given all the relevant facts. Again, if you think you need to seek medical attention, you probably do.
Preventing Swollen Eyelids
In some cases, measures can be taken to prevent a swollen eyelid. For example, to prevent a black eye, which typically results in a swollen eyelid, wear protective eyewear. Sunglasses made of polycarbonate are one way to protect the eyes from injury. Polycarbonate is a lightweight, shatter-resistant material with a UV coating. It is durable and is often used by children and athletes.
Additional ways to prevent swollen eyelids include:
- Avoid too much sodium, caffeine, and alcohol
- Get plenty of rest each night
- Apply cold compresses to your eyes before going to bed at night
- Avoid using hemorrhoid cream on your eyes; as we discussed earlier, this causes eye irritation
- Take medications as directed by your doctor
- Avoid irritants and known allergens
- Increase your intake of certain vitamins; your doctor can give you a list of foods to add to your diet that can improve the health of your eyes and skin.
- Drink plenty of water
- Talk with your eye-care professional about any problems with your eyes and eyelids
Talking to Your Eye Doctor
Swollen eyelids may come and go. During your next eye-doctor appointment, ask these questions to learn more about your condition:
- What is causing my swollen eyelids?
- What tests might help us to determine a cause?
- Is my medication causing the swelling? If so, what other medications can I try? What are the possible side effects of these medications?
- What can I do at home if my eyelids begin to swell?
- Which over-the-counter products work best for eyelid swelling?
- J. Lavine, MD “The Eye Care Sourcebook” (Contemporary Books, 2001) 29-30
- J. Weizer, MD; J. Stein, MD, MS “Reader’s Digest Guide to Eye Care” (Quantum Publishing, Ltd. 2009) 33
- J. Anshel, MD “Smart Medicine for Your Eyes” (SquareOne Publishing, 2011)
- The Straight Dope http://www.straightdope.com/columns/read/1308/does-preparation-h-cure-baggy-eyes
- The American Academy of Ophthalmology http://www.aao.org/eyenet/article/managing-blepharitis-tried-true-new-approaches?july-2012