SymptomEyes & vision
Swollen Eye: Common Causes and When to Worry
A swollen eye usually means swelling of the eyelids and tissue around the eye rather than the eyeball itself. Common causes are allergies, a stye or chalazion, pink eye, insect bites, rubbing, crying, too much salt or sleep, and minor injury. Swelling of only one eye that is red, hot and painful can be periorbital or orbital cellulitis, an infection that needs same-day care. Pain on moving the eye, a bulging eye, vision changes or fever are emergency signs.
Also called: Puffy eye, eye swelling, swollen eyelid, periorbital edema
At a glance
- What it is
- Puffiness of the eyelids and tissues around the eye, sometimes with redness, itching or pain.
- Most common causes
- Allergies, styes and chalazia, pink eye, insect bites, rubbing, crying and fluid retention overnight.
- Serious causes
- Periorbital or orbital cellulitis, severe allergic reactions, eye injuries and thyroid eye disease.
- One eye vs both
- One eye suggests a local cause such as a stye, bite or infection. Both eyes suggest allergy, fluid retention or kidney problems.
- Home care
- Cool compresses for allergy and bites, warm compresses for styes, no rubbing, and antihistamines for allergy.
When to get help
Call 911 or go to the ER
- Swelling with pain when moving the eye, a bulging eye, double vision or reduced vision (possible orbital cellulitis)
- Swelling of the eyes with swelling of the lips, tongue or throat, hives or difficulty breathing (anaphylaxis)
- Swelling after a blow to the eye with vision loss, blood in the front of the eye, or a pupil that looks abnormal
- Swelling after a chemical splash: rinse for 15 minutes with clean water and call 911 or your local emergency number or poison control
See a doctor within a day or two
- One swollen, red, warm and tender eyelid, especially with fever, in a child or adult (possible periorbital cellulitis)
- A swollen eye with severe pain, light sensitivity or thick discharge in a contact lens wearer
- Swollen eye in a baby under 3 months
Book a routine appointment
- Swelling of both eyes that keeps returning, especially with foamy urine or ankle swelling
- A painless lump in the eyelid lasting more than 4 weeks
- Eyes that look increasingly prominent or staring, with gritty or watery eyes
Usually safe to manage at home
- Puffy eyes in the morning that settle within an hour or two
- Itchy, puffy eyes during allergy season
- A small, tender stye on the lid edge without spreading redness
Causes of a swollen eye
| Cause | One or both | Key clues |
|---|---|---|
| Allergies | Usually both | Itching, watery eyes, sneezing, seasonal or around pets |
| Contact dermatitis | One or both | Itchy, dry, scaly lids after new makeup, eye drops or skin care |
| Stye | One | Painful red bump on the lid edge, may form a white head |
| Chalazion | One | Firm, painless lump in the lid, develops over weeks |
| Conjunctivitis | One then both | Red eye, discharge, gritty feeling |
| Insect bite | One | Sudden puffiness, often very swollen in the morning, itchy |
| Periorbital cellulitis | One | Red, warm, tender lid, often after a cold, sinusitis or scratch |
| Orbital cellulitis | One | Pain on eye movement, bulging, vision change, fever |
| Injury (black eye) | One | Bruising after trauma |
| Crying, salt, alcohol, sleep | Both | Puffy on waking, improves through the day |
| Kidney disease, nephrotic syndrome | Both | Puffiness on waking with foamy urine, ankle swelling |
| Thyroid eye disease | Both, may be uneven | Bulging, staring look, gritty eyes, double vision |
Allergies
Allergic swelling is the most common cause of puffy eyes in both eyes. Histamine makes blood vessels leaky, so fluid collects in the loose skin of the eyelids. Itching is the hallmark. See allergic conjunctivitis.
Stye and chalazion
A stye is an infected oil gland or lash follicle at the edge of the eyelid, causing a tender red bump. A chalazion is a blocked oil gland deeper in the lid that forms a firm, usually painless lump. Both can swell the whole lid.
Conjunctivitis
Conjunctivitis inflames the clear membrane over the white of the eye and inside the lids, causing redness, discharge and mild lid swelling.
Cellulitis around the eye
- Periorbital (preseptal) cellulitis: infection of the eyelid skin in front of the eye. It is common in children, often after a cold, sinus infection, insect bite or scratch. Vision and eye movement are normal. It needs antibiotics.
- Orbital cellulitis: infection behind the septum, around the eyeball itself, usually from sinusitis. It causes pain on eye movement, a bulging eye, reduced vision and fever. It is an emergency that can threaten sight and spread to the brain.
Injury
A blow to the eye causes swelling and bruising (black eye). Swelling can hide damage to the eye itself, so vision problems, blood in the eye or double vision need urgent assessment. Bilateral bruising around both eyes after a head injury ("raccoon eyes") can indicate a skull base fracture.
Swollen eye in the morning
Puffiness on waking is usually fluid that pools around the eyes while lying flat, worsened by salty food, alcohol, crying, allergies and poor sleep. It fades as you stay upright. Persistent morning swelling of both eyes with foamy urine or swelling elsewhere can be a sign of kidney disease and deserves a urine test.
How doctors assess a swollen eye
A doctor will ask about itching, pain, injury, recent colds, new products and vision. They check vision, eye movements, pupils, eye pressure if needed, and examine the lids and eye surface. A CT scan is done if orbital cellulitis or a fracture is suspected. Blood and urine tests check for kidney or thyroid causes when both eyes are repeatedly swollen.
Home care for a swollen eye
- Cool compress: a clean cloth soaked in cool water for 10 to 15 minutes, several times a day, for allergies, bites and minor injury.
- Warm compress: for styes and chalazia, 10 minutes, 3 to 4 times a day, then gently massage the lid toward the lashes.
- Do not rub or squeeze a stye.
- Antihistamines: oral non-drowsy antihistamines or antihistamine eye drops for allergy.
- Remove contact lenses until the swelling and redness settle.
- Stop new products: makeup, creams or eye drops that might be causing a reaction.
- Sleep with your head raised and reduce salt and alcohol if puffiness is worse in the morning.
- Clean lids gently with warm water.
Medical treatment
Treatment depends on the cause: antibiotics by mouth for periorbital cellulitis, IV antibiotics and sometimes surgery for orbital cellulitis, antibiotic drops for bacterial conjunctivitis, steroid injection or drainage for a persistent chalazion, and specialist care for thyroid eye disease.
Frequently asked questions
What causes one eye to swell?
One swollen eye usually has a local cause: a stye, chalazion, insect bite, injury, contact dermatitis or infection. If the eyelid is red, warm and tender, or you have fever or pain moving the eye, see a doctor the same day to rule out cellulitis.
How do you get rid of a swollen eye fast?
For allergy, bites or crying, use a cool compress for 10 to 15 minutes and an antihistamine if itchy. For a stye, use warm compresses. Keep your head raised and avoid rubbing. If swelling is painful, spreading or affects vision, get medical care.
Why is my eye swollen when I wake up?
Fluid settles around the eyes when you lie flat overnight. Salty food, alcohol, allergies, crying and poor sleep make it worse. It should improve within an hour or two of being upright. Persistent morning swelling of both eyes with foamy urine should be checked.
Is a swollen eye an emergency?
It is an emergency if you have pain on moving the eye, a bulging eye, double or reduced vision, fever with a red swollen lid, swelling after a significant injury, or swelling of the lips or throat with breathing difficulty. Most swollen eyes are not emergencies.
Can a sinus infection cause a swollen eye?
Yes. Sinus infections can spread to the tissues around the eye, causing periorbital or, more seriously, orbital cellulitis. Eye swelling with sinus symptoms, especially in a child, needs prompt medical assessment.
Sources
This guide was written from current patient and clinical guidance, including:
- American Academy of Ophthalmology: Swollen Eyelid; Chalazion and Stye
- MedlinePlus: Eyelid swelling
- NHS: Eyelid problems
- American Academy of Pediatrics: Periorbital and Orbital Cellulitis
- Mayo Clinic: Swollen eyes