Swollen Eyelids: Causes and Treatment
A swollen eyelid occurs when there is inflammation or excess fluid (edema) in the connective tissues surrounding the eye. Swollen eyes can be painful and non-painful, and affect both the upper and lower eyelids.
Symptoms of Swollen Eyes
Swelling of the eyelids is a symptom of an underlying cause, such as allergy or infection. Swollen eyes usually are accompanied by one or more of the following:
- Eye irritation, such as an itchy or scratchy sensation
- Excess tear production, resulting in watering eyes
- Obstructed vision (depending on the extent of the swelling)
- Redness of the eyelid
- Red eyes and inflammation of the conjunctiva
- Eye discharge, or "mattering"
- Eyelid dryness or flaking
- Pain, particularly when swollen eyelids are caused by infection
A swollen eyelid may be a symptom of allergies or a sign of a serious eye infection.
Puffy vs. Swollen Eyes?
The term "puffy eyes" often is interchangeable with "swollen eyes." Swollen eyes is generally used to describe an immune response to allergy, infection or injury, whereas "puffy eyes" is more likely used to refer to the external physical characteristic of swollen eyes from water retention, lack of sleep or genetic traits like dark circles under the eyes.
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Causes of Swollen Eyes
There are numerous causes of swollen eyelids ranging from mild to potentially sight-threatening conditions.
Allergies. Eye allergies occur when your immune system overreacts to a foreign substance, called an allergen. Pollen, dust, pet dander, certain eye drops and contact lens solutions are some of the most common eye allergens. An allergic reaction to makeup also is a known culprit of swollen eyes.
Eye allergies develop when your eyes release chemical "mediators" to protect your eyes from allergens to which you are sensitive.
The most common is histamine, which causes blood vessels in your eyes to dilate and swell, mucous membranes to itch and your eye to become red and watery.
Conjunctivitis. Also called "pink eye," conjunctivitis is inflammation of the clear lining of the surface of the eye, called the conjunctiva. Allergic, bacterial and viral types of pink eye can all result in swollen eyelids, among other symptoms such as watery, red and itchy eyes.
Styes. Usually appearing as a swollen, reddish bump on the edge of an eyelid, styes are caused by bacterial infection and inflammation of a meibomian gland. When these oil-producing glands get blocked, eyelid swelling is a typical symptom. A stye can cause the whole eyelid to swell, and typically is tender to the touch.
Chalazion. A chalazion, also caused by a blocked meibomian gland, at first mimics a stye but then develops into a hard sebaceous cyst. Another difference is that a stye occurs on the edge of an eyelid whereas a chalazion typically develops away from the eyelid edge. Both styes and chalazia cause swollen eyelids and tenderness of the affected area.
Eye injuries. Any trauma to the eye area, including an eyelid contusion (commonly known as a black eye) and trauma caused by cosmetic surgery (blepharoplasty, or eyelid surgery), can trigger inflammation and swollen eyes.
Contact lens wear. Improper care for contact lenses such as wearing dirty lenses, swimming in contact lenses or storing contacts in a dirty lens case can cause an eye infection and swollen eyelids. Using damaged contacts also can irritate eyes and cause your eyelids to swell.
Blepharitis. This is inflammation of the eyelids, usually caused by malfunctioning of the oil glands in the lids that empty near the base of the eyelashes.
Blepharitis is characterized by swollen and painful eyelids and can be accompanied by dandruff-like flaky eyelid skin and loss of eyelashes.
Blepharitis usually is a chronic condition, meaning symptoms can be controlled with proper treatment and hygiene practices, but it is never fully cured. It often is associated with a bacterial infection, but also can be attributed to acne rosacea and dry eye syndrome.
Orbital cellulitis. This is a rare but serious bacterial infection of tissues surrounding the eye, resulting in painful swelling of the upper and lower eyelid, and possibly the eyebrow and cheek. Other symptoms include bulging eyes, decreased vision, fever, and eye pain when moving the eyes.
Orbital cellulitis is a medical emergency and prompt IV antibiotic treatment often is needed to prevent optic nerve damage, permanent vision loss or blindness and other serious complications.
If the infection is limited to the soft tissue of the eyelids, this is called pre-septal cellulitis, which is less serious than orbital cellulitis and often can be treated with topical medication without hospitalization. However, sudden onset of the symptoms mentioned above should be considered a medical emergency until proven otherwise.
Symptoms of eye herpes can be similar to pink eye, however there may be painful sores on your eyelid, blurry vision due to a cloudy cornea and swollen eyes which may be so extreme that it obstructs your vision.
Types of eye herpes range from a mild infection to a more serious eye health problem that could result in a corneal transplant or even loss of vision.
Graves' disease. This ocular disorder, stemming from an overactive thyroid (hyperthyroidism), often is associated with swollen, puffy eyelids and bulging eyes, as well as double vision and drooping eyelids (ptosis). If you exhibit any of these symptoms, see your eye doctor as soon as possible for proper diagnosis and treatment.
Treatment of Swollen Eyes
Generally, if your swollen eyes are due to allergies, antihistamine eye drops or oral allergy medication, as well as lubricating "artificial tears" will help relieve symptoms. Your eye doctor also may recommend mild steroid drops for more severe allergic reactions.
Other causes, such as infection like conjunctivitis or ocular herpes, respond well to anti-viral or anti-inflammatory eye drops or ointments, or antibiotics.
Minor bouts of swollen eyelids can be eased with home remedies. First and foremost, avoid rubbing your eyes as this will only aggravate your condition.
Also, if you wear contact lenses, remove them until swelling resolves.
Applying a cool compress sometimes can reduce eyelid swelling, as well as splashes of cold water to your closed lids.
If symptoms continue or worsen, or if you experience any pain in your eye, see your eye doctor immediately to rule out a more sinister cause of your swollen eyes.
4 Tips for Preventing Swollen Eyes
- Get tested for allergies. If swollen eyelids and other symptoms of allergies are a regular occurrence, get yourself allergy tested. By knowing what you're allergic to, you can try to avoid specific allergens or, at the very least, minimize your exposure to them.
- Choose makeup and other beauty products that are hypoallergenic and fragrance-free to help avoid allergic flare-ups. You can also do a patch test on the inside of your wrist before using the makeup on your face to rule out any allergic reaction.
- When using eye drops, look for preservative-free eye drops. While preservatives in regular eye drops inhibit bacterial growth, some people are allergic to these preservatives.
- If you wear contact lenses, you can minimize your risk of eye infection or irritation by practicing proper hygiene techniques, including frequent replacement of your contact lenses and contact lens case.
[Page updated June 2015]