What causes puffy eyes?

We can all get puffy eyes from time to time. However, when it becomes a long-term problem or affects your vision, it’s time to consult a specialist. Expert ophthalmologist Miss Vickie Lee explains what causes puffy eyes and how to get rid of them.

Causes of puffy eyes

The tissues around the eyelids are very thin, so any accumulation of fluid in this area can cause obvious swelling. Typically, this is a temporary annoyance and will settle with a good night’s sleep and cold compresses. However, if it does not go away, or is causing significant pain or visual problems (decreased vision or double vision) then you should seek prompt attention from an eye care professional.

Puffy eyes can be caused by problems affecting the eye, the eyelids and/or eye socket (orbit). However, it can also be a sign of a more generalised condition.

Acute problems with the eyes that cause relatively painless eyelid swelling can be due to infections such as conjunctivitis or due to allergy. Trauma to the face can also cause eyelid bruising and swelling.

Localised eyelid swellings can be due to inflammation from blocked glands, e.g. chalazion or styes. More serious causes include infections (cellulitis, keratitis or dacrocysitis due to a blocked tear duct) and are usually associated with significant pain. Eyelid cancer can also be a relatively rare cause of eyelid swellings.

Other local causes of chronic upper eyelid drooping and swelling include one or a combination of the following:

• Excessive skin (dermatochalasis)
• Weakness/slippage of the muscle opening the eyelid (ptosis)
• Forward fat prolapse from fat pockets that normally cushion the eye deep in the eye socket

Generalised conditions that cause eyelid and facial swelling can be due to problems with the thyroid gland, the kidneys and other systemic disease.

How to get rid of puffy eyes

It is important to establish the correct cause of the swelling.

Infections and allergies in the eyes are usually treated with eye drops. Localised swelling due to blocked glands can usually be rapidly resolved with minor surgery. Cellulitis normally settles well with antibiotic tablets. Ptosis, excessive skin and fat prolapse can often be improved with eyelid surgery (ptosis correction and blepharoplasty. Eyelid cancer and blocked tear ducts can be also be treated with surgery.

If your doctor suspects that there is a more generalised cause for the eyelid swelling, they can arrange the necessary investigations to ensure you received the most appropriate care.

Visit Miss Lee’s Top Doctors profile to book an appointment.