Swollen Eyes & Swelling of the Eye

The term ‘swollen eyes‘ is often used to describe a range of eye swellings caused by a number of conditions. It is important to first differentiate whether the swelling is around the eye  (above, below or around the eyeball), a swelling of the eyelid or swelling of the eyeball itself. Other signs and symptoms may also assist with identifying the causative factors and this includes an itchy, red eye or darkening of the swelling itself as in trauma or a ‘black eye’.

Causes of Swollen Eyes

There are a number of possible causes for swollen eyes but the more common causes include :

  • Eye strain and/or lack of sleep (‘bags under the eyes’ or ‘baggy eyes’)
  • Dryness of the eye – environmental or pathological
  • Trauma – may be accompanied by redness of the eye and a bluish-black discoloration (black eye).
  • Allergy – accompanied by itching and redness of the eye with a sensation often described as ‘sand in the eyes’. Swelling around the eye is referred to as angioedema and often accompanies acute allergic reactions like hives (urticaria) (1)
  • Chalazion – caused by blockages of tiny glands just under the surface of the eyelid which produce lubricants for the eye.  (2)
  • Cellulitis – usually around the eyeball
  • Blepharitis – affects the lining of the eyelids
  • Conjunctivitis – affects the eyeball and is also called ‘red eye’ or ‘pink eye’
  • Stye (hordeolum)- usually caused by Staphylococcus aureus
  • Eyesight disorders
  • Post-operatively for any eye surgery including lasik surgery.

Symptoms

Apart from a clearly visible swelling of the eye, other signs and symptoms may also be present.

  • Redness of the eye, around the eye or eyelid.
  • Pain and/or itching of the eye itself, corners of the eye, around the eye or itching of the eyelids.
  • Dark discoloration associated with a hematoma as is ‘blue eye’ or ‘black eye’.
  • Blurred or reduced vision
  • Dry or watery (tearing) eyes

Diagnosis & Treatment of Swollen Eyes

Diagnosis is based on a case history and physical examination of the eye. In chronic cases of eye swelling, a consultation with an  opthamologist (eye specialist) is advisable. Specialized opthalmic investigation may be required in cases of cataracts or glaucomas. Infections require immediate medical intervention as prolonged eye infections can damage the eye or even spread to the brain due to the close proximity.

  • Anti-histamines may be used for allergies and itchy red eyes with no evident infection.
  • Antibiotics are required for bacterial infections and this can be taken orally or used as an antimicrobial eye drop. Viral and fungal infections of the eye are also possible and require specialist treatment. (3)
  • Corticosteroids may be used for severe swelling of the eye and surrounding tissue and steroid eye drops can also be used for inflammation of the eyeball.
  • While eyesight disorders may not often cause swelling of the eye, spectacles are advisable for relevant disorders.

Management of Eye Swelling

Always consult with your medical practitioner to exclude any serious pathology that may be causing swelling of the eye. In cases of eye strain, lack of sleep or injury around the eyeball caused by physical injury, a cold compress may be beneficial but should be applied lightly over the closed or covered eye. In cases of eye strain associated with prolonged reading, television or computer use, resting the eyes may also be helpful or changing the focus of the eye by looking at objects at varying distances intermittently. A saline eye drop may be useful for dry eyes although swelling eyes are not often caused by dryness.

References :

1. Hives and angioedema. Mayo Clinic

2. Chalazion. Patient UK

3. Eye Infections. American Academy of Opthamology

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  • Bev

    Below my eye puffs up like i have just been punchd. Wot could it be?

  • Dr. Chris

    Hi Bev

    There are a number of causes and is dependent on each case. It could be related to allergies, especially if you suffer with hay fever. You will notice that it usually flares up when your hay fever is affecting you the most. Puffy eyes may also be related to excessive use of drugs, alcohol, a lack of sleep or may be age related.

  • Pingback: Causes of Droopy Eyes and Ptosis | Current Health Articles 2009()

  • desteny

    My upper eyelid is has been swollen for 2 days now and it gets worse when I go to sleep and wake up the next morning. It also hurts really bad as if someone punched me in it. My mom doesnt think its a serious enough problem to see a physician but I think I need to. What should I do?

  • Dr. Chris

    Hi Desteny

    You should see your doctor because if it is due to any infection, this can progress and affect your eye or even permanently damage your eyesight.

  • Becky

    The white part of my eye has been swelling off and on for the last several months. It starts out as a burning sensation that itches. My eyeball begins to swell. The white part and the dark part(I have brown eyes)look seperated. It is very uncomfortable. When this happens I get a weird film in my eye. Do you think this is just standard hay fever or something else?

  • Dr. Chris

    Hi Becky
    Get it checked by an opthamologist. While this can occur in severe hay fever episodes, there could be more going on apart from your allergies. Persistent inflammation like this can also damage the eye and even affect your vision in the long run.

  • shunis

    Swollen around the eyes, itchy, puffy. I’ve been to an allergist, I’ve used neosporin, vigamox, patanol,and gentamicin sulfate ophthalmic 0.3%. My eyes are swollen to the point that it effects my seeing, let alone the way I look. Any suggestions? Thanks, Mark

  • Dr. Chris

    Hi Shunis

    We cannot suggest anything through this platform. That is not what it is intended for. The information you have provided is very limited – age, gender, past medical history, test results. The allergist must have referred you to a dermatologist, opthamologist or some other practitioner. I am sure he would not just have sent you away without any solution. Go back to him if you condition has not improved. This way he can follow through with the case rather than you moving on to the next doctor. You may want to read this article on What is Angioedema?

  • Raisa

    Hi,
    For a few days, my right eye has been slightly red. It only seems to itch in the late afternoon at which point it seems like there is a light film over the white part right beside the iris (though the film does not continue over the iris). I’ve checked and there is nothing in my eye whatsoever. The film only appears when it is itchy. Any suggestions? Thanks!

  • Dr. Chris

    Hi Raisa

    Itchy eyes at night is common symptoms of allergy associated eye complaints. In fact this is a characteristic symptom and is often associated with other allergic conditions like allergic rhinitis/hay fever. You should see an eye doctor (opthamologist) who can do a thorough examination and pressure test to exclude other eye diseases. If these are negative, an allergen test may be helpful. If you wear contact lenses, then there can be many other causes.

  • Tricia

    Late last night, my left eye started feeling weird. It started swelling in the inner corner near the nose – I could see differentiated areas where some was swollen and some not. After a bit, the eyelids got puffy as well. Then the white part started getting red.

    I took a small dose of benedryl in case it was an allergic reaction, then went to sleep. (I took one pediatric fast-acting benedryl, which I have on hand for food and drug allergies. I’m an adult, so one tablet was a small dose.)

    This morning it is still red and still feels swollen, but it is generalized to the entire eye. I stopped in at my eye care clinic, but they told me they would need a referral from my primary care physician to be seen, and that is going to be a major hassle to arrange so I gave up.

    Is this probably an allergic reaction?

    The symptoms are only in the left eye – the right eye is not affected. I’m a contact wearer, but was not wearing them at the time. It’s possible I touched/scratched/rubbed my left eye before this happened, but I don’t remember doing it. I had been handling vegetables perhaps 10 minutes beforehand, but nothing unusual.

  • Dr. Chris

    Hi Tricia

    It is difficult to say without seeing the eye. Yes, it could be an allergic reaction and a higher dose of an antihistamine is required in such an acute case to conclusively confirm that it is an allergic reaction. There is also the possibility of an infection as well as keratitis (although unlikely in such sudden onset) which needs to be excluded, especially since you are a contact lens user. The infection could have been passed on from the vegetables you were handling. In addition, minute particles in the eye are less likely to be felt in a contact lens user due to changes in the conjunctiva hat occurs with long term use of contact lenses. You should not leave this unattended. You need to see a doctor ASAP as an eye infection can quickly progress to damage the eye significantly and lead to loss of vision.

  • ravi

    hai
    my mother having some problem swelling pain itch and some marks around the skin (on eyelids and below the eyes, round the eyes) it is occurring often or some times it wont be there but i have noticed that it starts when she woke up in the morning.from last 2 or 3 years she is having the problem shown to eye doctors also but they say some allergies. but no worth please suggest me

  • Dr. Chris

    Hi Ravi

    Swelling, redness, itching and tearing of the eye, especially at night or in the morning, are typical signs of an allergy so her doctors are correct. It would be advisable to run an IgE test and even a RAST screen to try to identify the cause if possible. Antihistamines and corticosteroids, eye drops or systemic, would help. Your mum should see an opthamologist (eye specialist) just to exclude other possible problems.

  • chad

    I’ve had a headache “behind my eyes” for about a week now. Feels like pressure on the eyeballs. For the last couple days it’s only been on the left eye. It hurts when i move the left eyeball in any direction and my vision has become a little blurry in that eye, like there is an invisible film over it. The eyeball is not red or inflamed looking? It looks normal? i don’t have any allergies that I’m aware of? doesn’t feel like anything is stuck in my eye? Don’t think I scratched it or poked it?

  • uju

    hi doc
    2months after cataract surgery,i still have itching and yesterday,my eye became red and swollen i can barely see with it

  • Dr. Chris

    Hi Chad

    It could be related to the eye muscles that are responsible for movement of the eyeball. May also be a case of eye strain. Despite the lack of redness, an infection should still be excluded. Some viral infections will not cause such obvious symptoms and can be quite selective in the area that is affected. This is being rather cautious but when it comes to organs like the eye, it is important to be safe than sorry. Considering that this has now lasted for a week, it is important to see a doctor, preferably opthamologist. Eye strain can explain much of your symptoms so try to not to strain it further with watching TV or working for long hours on the computer. Your vision may also need to be checked. See an eye doctor as soon as you can.

  • Dr. Chris

    Hi Uju

    You need to see an opthamologist, preferably the same specialist who did the surgery. It may not be related to the surgery since these symptoms started up 2 months later. Could be an allergy or infection. See your doctor.

  • Asma

    Hi doc..
    I have a swollen upper eye lid for past 3 days and the pain is getting worse. When I read something or use computer too much, my other eye also gets red and itchy. It happens almost every month and I’m unable to identify the reason. Some suggest I’m allergic to eyeliner that I use because it usually happens the next day of it but not always. I also have dust allergies. However, the doctors never give any reason and just give me a cream or eyedrops. I’m sick of it. I also experience constant itching and irritation in my eyes even when the eye is not swollen. Please help!

  • Dr. Chris

    Hi Asma

    This could just be a case of severe eye strain which is further complicating your pre-existing allergy. However, eye strain will not explain the swollen eyelid. This could be due to the allergy as well (if it is recurrent and not paining) or it may be an infection (pain will be evident). You need to see an opthamologist (specialist eye doctor). With proper treatment, the discomfort can be minimized.

  • Bea

    hi doc,
    my left eye has been swollen for a few days now. i dont feel any pain or discomfort. i see just fine with it. it is not red or itchy. no symptoms at all. my mother was really the first one to notice. she said it looked as if one eye was smaller. when i took a pic of my face you could clearly see that one eyelid is swollen..drooping. which is given it the effect of looking smaller. i was a contact user for many years but have recently changed to glasses. also i spend many hours in front of my laptop due to work. i went to my opthamologist and he said it was fluid in my eyelid and said i should apply warm compresses. but looking at in the mirror it seems like one eyeball is larger. not just the eyelid.

  • hui

    Hi Doc,

    the inner side of my left eye (where the bump is) itches at night only.
    it happens almost every night and eye drops (OTC) doesnt really help.

  • Dr. Chris

    Hi Bea

    Firsty you have to exclude the various causes of a droopy lid or lid lag. This is discussed in the article on Droopy Eyes. It is unlikely although possible that one eyeball is larger than the other and if your vision is also affected you need to see a doctor as soon as possible. It is possible that the puffiness is around the entire eye thereby giving the impression that the eye is smaller. I would recommend that you go back to your opthamologist and express your concerns so that he/she can advise you further. If you are not satisfied, then you should see a second opinion.

  • Dr. Chris

    Hi Hui

    If there is no lump on the inner part of the eyelid, then it is most likely allergy related and will require steroid eyedrops. See a doctor, preferably an opthamologist (eye doctor), who can assess this properly.

  • vicky12345

    Hi Doc,
    My son, 3yrs old, had a pinkish bulge on the tear duct of the Rt eye,
    When that was treated, a pea shaped bulge appeared on that eye(inside of the upper eyelid). later it subsided only to reoccur in the other eye(inside of the upper eyelid) and it has refused to subside.
    Vicky

  • Dr. Chris

    Hi Vicky12345

    This may be a chalazion which is a blockage of the gland or duct. It may be due to an infection or even related to allergies. Since it is recurrent, you should take your son to an opthamologist (eye specialist) because it needs to be treated and managed so that it does not recur.

  • stephanie

    Hi. Ii got poked in the eye about a yr ago. My eye doctor to me a had a foreign body that got healed over and to use eye drops. When i went back she saint everything was fine. Now ever since this morning it hurts to close my eye and has been watering for about 8 hours and my upper and lower lids are swollen. It is also causing my headache. Im currently on doxycycline for acne prescribed my dermatologist and have been taking benadryl and nothing has worked yet. Should i go to the doctor or wait to see if this gets better?