The term ‘swollen eyes‘ is a symptom whereby the eye and even the area of the eye is enlarged due to fluid accumulation. 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’. Any disturbance of vision requires immediate medical assessment. The treatment and management of eye swelling varies depending on the underlying cause.
Causes of Swollen Eyes
There are a number of possible causes for swollen eyes. Most of the time it is sign of an eye-related condition but at times may also occur with other conditions that do not directly involve the eye. Eye swelling should not be confused with protruding or bulging of the eyeball, which is a condition known as exopthalmos. Most of the time this eye bulging is due to hyperthyroidism, specifically Grave’s disease.
Eye swelling is where fluid accumulates in the tissue of the eye, eyelids or around the eye (orbit) and may be caused by one of the following conditions:
- Eye strain is one of the most common causes and is largely due to prolonged screen use these days. It is also more likely to affect people with eyesight disorders who do not use proper corrective eyewear.
- Lack of sleep where a person has less than 5 hours of sleep, especially on a repeated basis, can present with eye symptoms like dryness and swelling.
- Dryness of the eye may be caused by environmental factors like airconditioning or diseases such as Sjogren syndrome.
- Trauma may be due to physical factors like a blow to the eye or chemical factors like when chlorine makes contact with the eye.
- Allergy is an immune reaction to harmless substances (allergens) like pollen and dust. Eye allergies ar emore likely to occur in hypersensitive people. It may affect the eyes (allergic conjunctivitis) or eyelids (allergic blepharitis).
- Angioedema is swelling around the eye and eyelids and often accompanies acute immune allergic-like reactions such as hives (urticaria) (1)
- Contact dermatitis is an inflammatory skin condition caused by skin contact with certain substances. These substances, either irritants or allergens, may include soaps, eye makeup and other cosmetics and even prolonged exposure to tears.
- Chalazion is caused by blockages of tiny glands just under the surface of the eyelid which produce lubricants for the eye. (2)
- Infections may affect the eyelids (blepharitis), lining of the eye (conjunctivitis or ‘pink eye’) and sometimes the area around the eyeball (orbital cellulitis). A stye (hordeolum) is usually caused by Staphylococcus aureus.
- Surgery to the eye, eyelid and around the eye also causes swelling which can be exacerbated in the event of a post-operative infection.
Eye swelling is a sign of inflammation and not a disease or disorder on its own. It is often accompanied bya host of other signs and symptoms such as:
- 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 vision or diminished vision.
- Dry eyes or watery (tearing) eyes.
It is imperative that medical attention is sough for eye swelling even if other symptoms are not present. The eye tissue is very delicate and can be easily damaged. This can cause permanent impairment of eye function, namely the loss of vision.
Read more on puffy 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. It counteracts the chemical that is secreted in allergic reactions which facilitates inflammation.
- 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)
- Antivirals are rarely prescribed in oral or topical form for viral infections of the eye as these conditons are usually acute and self-resolving.
- 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.
A common practice is to apply an ice pack over the eye area following a blunt force injury to the eye. Cold helps to minimize inflammation but is only effective for acute injuries. Never apply ice directly to the skin or eye. While eyesight disorders may not often cause swelling of the eye, prescription spectacles or contact lenses should be used as required to prevent eyestrain.
Management of Eye Swelling
Always consult with your medical practitioner to exclude any serious pathology that may be causing swelling of the eye. The prescribed medication should always be followed and further medical assessment may be necessary if the symptoms do not resolve. 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.
For 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. This is known as the 20-20-20 rule where a person should look at an object 20 feet away for at leas 20 seconds every 20 minutes. A saline eye drop may be useful for dry eyes although swelling eyes are not often caused by dryness.
1. Hives and angioedema. Mayo Clinic
2. Chalazion. Patient UK
3. Eye Infections. American Academy of Opthamology