Puffy eyes

The medical term for puffy eyes is periorbital edema, and it refers to general inflammation around the eye which causes a build up of fluid. It’s common, and often caused by an infection, or a reaction to an allergen. The eyelid is the most common area of the eye to swell.

  • Usually caused by a temporary condition
  • Other symptoms are usually localised to the eye
  • Treatment varies, depending on the underlying cause

If you are concerned about your eyes appearing puffy or swollen, you can speak to a doctor online using our online video consultation service. One of our GMC-registered clinicians can help you to manage the swelling and treat the underlying condition, from 9.30am-4.30pm, Monday to Friday.

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Possible causes

What causes puffy eyes?

The causes of puffy eyes can be split into two categories: fluid retention causes, and causes due to allergy or infection.

Fluid retention causes

Often, fluid retention in the eye can be due to age, lifestyle factors or medical conditions. Some common causes include:

  • issues with the thyroid such as hypothyroidism and hyperthyroidism
  • skin disorders
  • a dysfunction of the tear ducts
  • crying irritating the skin around the eyes
  • the natural process of ageing, leading the body to expel more water in a day, so fluid is retained in the eyes to counter this loss
  • too much or too little sleep 
  • or a diet which is too high in salt, so the body naturally retains more fluid.

In many cases, the process of fluid retention which causes puffy eyes can develop over a long time. It’s rare that fluid retention is an acute condition that happens suddenly.

Allergy and infection

When the immune system reacts to a foreign substance that may have entered the eye such as pollen, dust, or the solution for contact lenses, the eye can often become swollen. It will often be itchy and red due to histamine being released.

The most common infectious causes of puffy eyes are blepharitis, styes and conjunctivitis. Conjunctivitis is more commonly referred to as ‘pink eye’. It’s characterised by inflammation of the conjunctiva due to bacterial or viral infection, and causes the eyelids to swell. 

A stye is a red bump which appears on the edge of the eyelid. It occurs when the meibomian gland is blocked due to a bacterial infection. 

Blepharitis is the inflammation of the eyelids due to the oil glands in them malfunctioning. It can often be painful.

Although rare, puffy eyes can be an indication of a serious condition such as orbital cellulitis, which is a bacterial infection, and causes the eye to bulge. It requires urgent hospital admission to prevent permanent nerve damage.

Diagnosing the cause of puffy eyes

To diagnose the cause of puffy eyes, a doctor will ask you some questions about your medical history, before examining the eye. They may also conduct some tests if the diagnosis has not already been confirmed.

A clinician is likely to ask when the swelling started, and how quickly it came about. They will also want to rule out any possible systemic causes by asking whether you have any other symptoms which are not localised to the eye. A doctor may also ask you to describe the nature of your symptoms in more detail; for example, whether the eye is particularly itchy or painful, or whether the swelling is the only symptom. They will look to establish whether you have recently come into contact with any known allergens, or if any foreign substances have entered the eye.

After your patient history has been determined, a clinician will look at where the swelling is located on the eye. They may ask you to move the eyelid to assess how affected the eye is by the swelling. They may also use a slit lamp, which involves using a microscope and a powerful light to look closer into the eye.

Once a physical examination has taken place, a doctor may want to perform some additional tests. For example, if a suspected thyroid abnormality is the cause, then blood tests will be necessary. Allergy tests may also be required if a suspected undiagnosed allergy is the cause. A skin biopsy can be taken if a doctor thinks that a skin disorder may have caused the swelling.

If you want to speak to a doctor online about puffy eyes, one of our GMC-registered clinicians can consult you using our video consultation service. They can discuss your symptoms, prescriptions and referral to specialists with you, if appropriate, from 9.30am-4.30pm, five days a week. 

Page last reviewed:  11/06/2020
Types of Treatment

How are puffy eyes treated?

Puffy eyes can be treated in a variety of ways depending on what the cause is. It’s common for no treatment to be required for an infection, but medication and over-the-counter remedies may also be recommended.

If the cause of your puffy eyes is related to an allergy, antihistamine eye drops are available, as well as allergy medication. If the eyes have also become dry, a doctor may prescribe artificial tears which can lubricate the eyes. More severe allergic reactions may warrant steroid drops, or in the case of anaphylaxis, the use of an adrenaline pen and urgent hospital admission.

For conjunctivitis, anti-inflammatory eye drops can be used, or certain ointments can gently be applied to the eyelids. The cleaning process is very important to stop the infection from spreading to others, as it can be very contagious. It’s recommended that you use a piece of cotton wool to rub crust from the eyelashes, and use a cold flannel to prevent the swelling.

Blepharitis is a chronic condition, and although there is no specific cure for it, cleaning the eye when flare-ups occur is important. Antibiotic eye drops can be used in cases where the eye does not respond well to simple cleaning.

If the puffiness around your eyes is found to be caused by hypothyroidism or hyperthyroidism, you will need some form of hormone therapy. This is normally either hormone replacement for hypothyroidism or medication which limits the activity of the thyroid. 

A facial injury can sometimes have an impact on the tear ducts and lead to dysfunction. When this occurs, a doctor will often suggest allowing the injury to heal before acting on the tear ducts. However, if they do not resolve themselves, a doctor can conduct a procedure that irrigates the tear duct with a very small probe, which can provide temporary relief.

What you can do to help puffy eyes

When a lifestyle factor is causing puffy eyes, adjustments need to be made to address this. Puffy eyes is usually a temporary cause of sleep deprivation or excessive sleep, and can worsen if one of these two factors persists. Improving your sleeping pattern by regulating the amount of time you sleep can help. Reducing the amount of salt in your diet can help the body to expel fluid with more efficiency, and prevent a build-up around the eyes.

Puffy eyes can vary from being a minor issue to a serious inconvenience, interfering with your daily life. One of our GPhC-registered clinicians can speak to you about how you can manage symptoms and what treatment options are available. You can book an appointment to consult one of them via our online video consultation service, which is available between 9.30am and 4.30pm, five days a week.

Page last reviewed:  11/06/2020
Questions and Answers

How long is it normal to have puffy eyes for?

The length of time for which you will have puffy eyes depends entirely on the cause. If symptoms occur as a result of an infection such as conjunctivitis, it will usually take between 5 and 10 days for it to clear. If puffy eyes have occured due to a natural process related to aging, however, this is a permanent symptom which is difficult to change.

Are puffy eyes serious?

In most cases, puffy eyes are not an indication of a serious condition. Even if the cause is infectious, they rarely cause complications, provided that they are treated properly. However, in the case of orbital cellulitis, which is a type of bacterial infection, it’s vital that someone is admitted to hospital quickly to reduce the risks of them losing their sight, or suffering permanent nerve damage.

Sometimes puffy eyes can be a sign of an undiagnosed thyroid problem. Further investigation will be required to make a diagnosis, but thyroid conditions will often warrant long-term treatment.

Can I get treatment for puffy eyes?

Puffy eyes do not often require treatment if the cause is temporary, and will pass without the need for medication. Antiviral, antibiotic and ‘artificial tear’ eye drops may be prescribed for a number of infections and allergies, however. As an accompaniment to eye drops, learning how to clean the eye properly is important.

How can I prevent puffy eyes?

There are a few preventative measures for general puffy eyes which do not have an infectious or allergic cause. 

Reducing your consumption of salt, sleeping properly and staying hydrated can all help contribute to preventing puffy eyes.

Can I speak to a doctor about puffy eyes?

If you want to speak to a doctor online about puffy eyes, you can use our video consultation service. Our clinicians can provide advice, referral to specialists and prescriptions, where appropriate, from 9.30am-4.30pm, Monday to Friday. 

Page last reviewed:  11/06/2020

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