10 Causes of Eyelid Swelling & Treatment Options

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Overview: Eyelid Swelling 

Eyelid swelling occurs when the area around your eyes fills up with fluid. This condition is also known as "puffy eyes." 

The eyelids may swell due to a localized infection, trauma, or any disease that encourages fluid retention.

Eyelid swellings can occur in one or both eyes.

Other Symptoms That May Occur With Eyelid Swelling

Minor symptoms:

  • Irritation in the eyes in the form of an itchy or scratchy sensation
  • Sensitivity to light
  • Reddening of eyelids
  • Eye discharge
  • Eyelid dryness
  • Excess tearing
  • Obstructed vision due to swollen eyelid
  • Redness of the eyes
  • Scaly or flaking skin around the eye

Moderate symptoms:

  • Fatigue
  • Fever
  • Sneezing/runny nose
  • Headache
  • High blood pressure
  • Facial pain and swelling
  • Anxiety
  • Difficulty concentrating

 Serious symptoms:

  • High fever
  • Acute vision loss
  • Severe headache
  • Bulging eyes accompanied by fever and pain
  • Painful eye movement
  • Swollen tongue
  • Stiff neck
  • Itchy throat or mouth
  • General edema (swelling)
  • Difficulty breathing

10 Causes of Swollen Eyelids

There are many reasons why your eyelids may be swollen. They include the following:

1. Eye Allergies

Seasonal allergies, such as hay fever, as well as allergic responses to foods, medications, and insect bites, can all cause eyelid swelling.1

If one of your eyelids is inflamed, red, and itchy, it is most likely due to an allergic response to something in your eye (e.g.,animal dander, pollen, or dust).

Symptoms include:

  • Pink or red eyes
  • Eye pain in one or both eyes
  • Puffy eyelid
  • Itchiness in the eyes

Complications:

  • Extreme pain in the eyes
  • Extreme sensitivity to light
  • Vision issues
  • Super red eyes

Treatment options:

  • Antihistamines to reduce symptoms such as itchy eyes, sneezing, or sinus pressure
  • Rinsing eyes with sterile saline solution
  • Using artificial tears to soothe itching and help flush allergens out of the eye
  • Using allergy eye drops to relieve itching 
  • In case of severe swelling of the face, lips, and tongue, seek immediate medical attention or call 911

2. Conjunctivitis (pink eye)

Conjunctivitis is an infection of the conjunctiva (the thin tissue that lines your eyelids and covers the white of your eye). Most cases are related to adenovirus, which also causes cold symptoms and pneumonia.

Allergic reactions can also cause conjunctivitis. The condition can affect one or both eyes.

Symptoms include:

  • Swelling
  • Redness 
  • Itching in the eyes
  • Watery eyes due to excess tearing
  • Eye discharge (may be watery or mucous depending on the cause)

Complications:

  • Punctate keratitis (death of cells in the cornea)
  • conjunctival scarring
  • severe dry eyes
  • corneal ulceration
  • chronic infection

Treatment options:

Infectious viral conjunctivitis is very contagious and requires professional medical attention.

Pink eye therapy is often aimed at symptom alleviation. Your doctor may advise you to use artificial tears, wipe your eyes with a wet cloth, and apply cold or warm compresses multiple times each day.2

In case of allergic reactions, your eye doctor may prescribe antihistamines, steroids, mast cell stabilizers, or anti-inflammatory drops.

3. Herpes Infection (Ocular herpes)

Eye herpes, sometimes termed ocular herpes, may produce painful sores on the eyelid or the eye surface itself. Both the cornea and the eyelid may be affected.

Symptoms include:

  • Eyelids stuck together with mucus in the morning
  • Swollen eyelids
  • Red, itchy, and irritated eyelids
  • Eye pain
  • Tearing
  • Reduced vision

Complications:

  • Damage or scarring of the cornea
  • Risk of secondary infections such as bacterial infections
  • Eye inflammation
  • Increase in eye pressure

Treatment options:

  • Oral antiviral medications
  • Antiviral ointments (to apply on the eyelids)
  • Antiviral eye drops
  • Antibiotic eye drops (to prevent bacterial infection)

4. Cellulitis

Cellulitis is a more severe cause of swelling of the eyelids. It is a bacterial infection of the skin. 

When someone comes in with eyelid swelling, there are two major kinds that eye physicians look for: preseptal cellulitis and orbital cellulitis.3 

Preseptal cellulitis is a skin infection that affects the eyelid and/or surrounding skin. People often experience red eyes, as well as pain from swelling. In most cases, it only affects one eye.

Orbital cellulitis is an infection of the tissues around and behind the eye. This condition may be related to sinus infection or can develop from an existing preseptal cellulitis. The infection spreads into the region surrounding the eye sockets.

Symptoms include:

People suffering from orbital cellulitis may experience a bulging eye and pain while shifting their eyes back and forth. Other symptoms include:

  • Warm skin
  • Eye pain
  • Blisters around the affected area
  • Fever
  • Headache
  • Swelling and redness of the skin

Complications:

  • Sepsis (entry of bacteria into the blood)
  • Necrotizing fasciitis (when the infection spreads to tissues)

Treatment includes antibiotic therapy targeting the bacteria. Symptoms often improve within 24 to 48 hours.

5. Graves' Disease

Grave's disease is a thyroid problem that can cause the eyelids to swell or bulge out of the sockets. 

According to research, hyperthyroidism (high levels of thyroid hormones) can cause the eyes to swell or seem puffy.4 This is because the condition affects muscles and tissues around the eye.

Symptoms include:

  • Eyes bulging from the eye socket
  • Red, irritated eyes
  • Double vision or reduced vision
  • Sensitivity to light
  • Gritty sensation in the eyes
  • Pressure or pain in the eyes

Treatment options:

  • Using artificial tears or eye drops to minimize irritation
  • Use of steroids to reduce swelling
  • FDA approved Tepezza, which reduces eye protrusion5
  • Radiation such as Orbital radiotherapy
  • Orbital decompression surgery to fix bulging eyes

6. Chalazion

A chalazion is a blocked gland on the inner rim of the upper or lower eyelid.6 It is usually a  painless swelling.

The swelling is typically localized, although it may affect the whole eyelid, obstructing vision.

Rosacea patients stand a higher risk of developing chalazions. This is a chronic condition that causes inflammation of the skin on the face. 

Symptoms include:

  • Increased tear production
  • Irritated eye
  • Soft bump below the eyelids
  • Swelling around the eyes

Complications:

  • Blurry vision
  • Persistent eyelid lump
  • Loss of eyelashes around the affected area
  • Cancer of the eyelids (can be mistaken for a chalazion)

Treatment options:

Most cases of chalazion are treated at home. You can do the following:

  • Apply a damp compress several times a day
  • Practice good hygiene on the affected area
  • Gentle eyelid massages

7. Stye

A stye or hordeolum is a sensitive red lump caused by inflammation of the eyelash follicles.7 

A stye typically has pus in the middle of the enlarged eyelid and is characterized by a feeling of itchiness, pain, and tenderness. 

Symptoms include:

  • Watery eyes
  • Eyes may feel bruised
  • Sensitivity to light
  • A painful lump that feels better once it pops

Complications:

  • If left untreated, a stye can develop into a chalazion

Treatment options:

  • Warm compress (apply a warm washcloth on the affected eye)
  • Gentle eyelid massage
  • Eye drops and other antibiotic ointments
  • Eyelid scrubs to get rid of bacteria and dirt

Consult your healthcare professional for more advanced care if your stye lasts longer than a week despite home remedies.

8. Blepharitis

Blepharitis is an inflammation of the eyelash follicles and the skin around the upper and lower eyelid margins.8 Blepharitis causes the eyelid margins to swell, flake, and scale.

This illness is caused by an overgrowth of bacteria usually present on the eyelids. 

According to the National Eye Institute, there are 2 types of blepharitis:9

  • Anterior blepharitis affects the exterior of the eye (the part where eyelashes attach)
  • Posterior blepharitis affects the inner edge of the eyelid (the part in contact with the eye), including the oil glands of the eyelid

Symptoms include:

  • Crusted eyelid margins
  • Dry eyes
  • Loss of eyelashes
  • Watery eyes
  • Itchy and gritty feeling in the eyes
  • Eye discharge
  • Red or sore eyes
  • A build-up of eyelid debris

Complications:

Seek immediate medical attention if you experience the following:

  • Sudden vision change 
  • Vision loss
  • Chronic dry eyes
  • Corneal abrasion (scarring of the cornea)
  • Increased sensitivity to light

Treatment options:

  • Antibiotic ointments to suppress bacterial growth
  • Topical steroids to reduce swelling
  • Good eye hygiene practices such as eyelid scrubs

9. Eye Trauma

Eyelid swelling may be caused by skull fractures, burns, direct impact, foreign objects in the eye, and surgery. 

Eye injury should always be examined by a qualified healthcare professional to rule out any potential dangers.

Symptoms include:

  • Pain and swelling of the eye
  • Visual issues
  • Cut, torn, or inflamed eyelids
  • Unusual pupil shape
  • Reddening of the eyes
  • A gritty feeling in the eyes

Treatment options:

  • Gentle cold compress 
  • Eye flushing to remove any chemicals or irritants
  • Eye drops to help with healing
  • An eye patch to cover the eye while it's healing

10. Eye cancer

Although rare, eye cancer is associated with swelling of the eyelids. 

Eye cancer occurs when there is an abnormal growth of cells in the eyes, resulting in a swelling commonly referred to as a tumor.10

Symptoms include:

  • Blurred vision
  • Swollen eyelids
  • Bulging of the affected eye
  • Partial or total vision loss
  • Pain in or around the eye (rare)

Treatment options:

  • Radiotherapy
  • Chemotherapy
  • Surgical removal of the tumor

When Should You Worry About a Swollen Eyelid?

Eyelid swelling usually goes away within 24 to 48 hours. 

However, you may need to seek immediate medical attention in some circumstances. 

When to See a Doctor

If your eyelid remains swollen for more than 48 hours, it's time to seek immediate medical attention. 

Severe symptoms to watch out for include:

  • Sudden vision loss
  • Painful eye movements
  • Swelling after head trauma
  • Anaphylaxis symptoms such as swelling of the tongue, lips, and mouth
  • Bulging eyes
  • Severe headache
  • Stiff neck
  • Severe fever (higher than 101 degrees Fahrenheit)

A physician or eye doctor will diagnose your condition and prepare you for treatment. If the reason for the swollen eyelid is severe enough, an ophthalmologist referral may be required.

Treatment Options for Swollen Eyelids 

You can treat most cases of eyelid swelling at home with easy home treatments such as cold compresses for periodic eye redness and swelling. 

Chronic cases should be examined by a doctor immediately.

Common medical treatments for swollen eyes include:

  • Allergy treatments (allergy shots and prescription medicines)
  • Antibiotic eye drops for bacterial infections
  • Antiviral eye drops for viral eye infections such as herpes
  • Administration of corticosteroids to ease the inflammation
  • incision and drainage of styes and chalazions 
  • Surgical removal of foreign objects in the eyelid

Common home remedies for swollen eyelids include the following:

  • Clean the skin around your affected eyelids gently using water and baby shampoo, then gently pat the area dry.
  • Use artificial tears to rinse and moisten your eyes if you're experiencing dry eyes
  • Apply cool compresses on the affected area
  • Rest with your head elevated to drain fluids away from the eyes
  • Avoid contact lenses until your swollen eyelids fully recover

Contact a healthcare expert immediately away if your eyelids swell as a result of a serious allergic reaction. 

Self-care techniques may still help minimize swelling. An injection of epinephrine at the doctor's office or emergency room may be required to calm the reaction.

How to Prevent Eyelid Swelling 

Eyelid swelling prevention tips include:

  • Get examined for allergies. If allergies cause swollen eyelids frequently, understanding what you're allergic to may help you avoid or limit your exposure to particular allergens.
  • Maintain proper eye hygiene. Neglecting your eyes increases the risk of bacterial and viral infections that can cause your eyes to swell.
  • Buy beauty products that are hypoallergenic to avoid flare-ups. It's always recommended doing a patch test on the wrist to check for any potential skin reactions.
  • Handle your contacts with care. Contact lenses are good but can be a haven for bacteria if exposed to contaminated surfaces or used for extended periods.
  • Attend regular eye checkups. This will help your doctor discover the condition before it worsens.
Resources
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What Are Eye Allergies?,” American Academy of Ophthalmology, 10 September, 2010

Pink eye (conjunctivitis),” Mayo Foundation for Medical Education and Research (MFMER)

Periorbital and Orbital Cellulitis,” American Medical Association, 14 January, 2020

Hypothyroidism symptoms: Can hypothyroidism cause eye problems?,” Mayo Foundation for Medical Education and Research (MFMER)

FDA approves first treatment for thyroid eye disease,” US Food and Drug Administration (FDA), 21 january, 2020

Chalazion,” American Optometric Association

Hordeolum (Stye),” The Johns Hopkins University

Blepharitis,” American Optometric Association

At a glance: Blepharitis,” National Eye Institute, 31 August, 2020

Eye cancer,” National Health Service (NHS-UK)

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