SymptomEyes & vision
Swollen Eyelids: Common Causes and What to Do
Swollen eyelids are puffy, enlarged lids on one or both eyes. The commonest causes are allergies (itchy, both eyes), a stye (a painful red bump at the lash line), a chalazion (a painless lump in the lid), blepharitis and conjunctivitis. Fluid retention, crying and sleeping face-down cause morning puffiness. Swelling that is red, hot and spreading, with fever, pain on moving the eye or vision changes, may be orbital cellulitis and needs emergency care.
Also called: Puffy eyelids, eyelid edema, swollen eye, palpebral edema
At a glance
- What it is
- Puffiness or swelling of the upper or lower eyelid.
- Most common causes
- Allergies, styes, chalazia, blepharitis, conjunctivitis, insect bites.
- Other causes
- Fluid retention, kidney or thyroid disease, angioedema, injury, cellulitis.
- Diagnosis
- Eye and lid examination. Blood or urine tests if both lids swell without an eye cause.
- Treatment
- Cold or warm compresses depending on cause, antihistamines, lid hygiene, antibiotics for infection.
When to get help
Call 911 or go to the ER
- Eyelid swelling with lip, tongue or throat swelling, hives or trouble breathing (possible anaphylaxis): call 911 or your local emergency number
- Red, hot, swollen lid with fever, a bulging eye, pain on moving the eye, double vision or reduced vision (possible orbital cellulitis)
- Swelling after a chemical splash or a penetrating injury
See a doctor within a day or two
- Red, tender, spreading lid swelling, especially in a child
- Swelling after a blow to the eye with blurred vision, double vision or numb cheek
- Severe eye pain or sensitivity to light with the swelling
Book a routine appointment
- Swelling of both lids most mornings, with swollen ankles or foamy urine
- A lid lump that has not gone after 4 weeks of warm compresses
- Puffy eyes with bulging, staring eyes or thyroid symptoms
Usually safe to manage at home
- Itchy, puffy lids with sneezing on high-pollen days
- A small, tender stye on the lash line without spreading redness
Swollen eyelid causes at a glance
| Cause | Typical features |
|---|---|
| Allergy | Both eyes, itchy, watery, pale or pink puffy lids, sneezing |
| Contact dermatitis | Itchy, dry, red lid skin after a new cosmetic, hair dye or eye drop |
| Stye (hordeolum) | Painful red bump at the lash line or inside the lid, often with a yellow head |
| Chalazion | Firm, usually painless lump in the lid, develops over weeks |
| Blepharitis | Red, crusty lid margins, gritty eyes, both sides |
| Conjunctivitis | Red eye, discharge, mild lid swelling |
| Insect bite | Sudden one-sided swelling, itching, may look alarming but is not painful |
| Preseptal cellulitis | Red, warm, tender swollen lid, eye itself normal |
| Orbital cellulitis | Red swollen lid with pain on eye movement, bulging eye, vision changes, fever |
| Fluid retention | Both lids, worse on waking, improves through the day |
Common causes
Allergies
Eye allergies cause itching, watering and puffy lids, usually in both eyes. Pollen, pet dander, dust mites and mold are common triggers. Rubbing worsens swelling. See conjunctivitis for the allergic, viral and bacterial types.
Styes and chalazia
A stye is an infected eyelash follicle or oil gland. It is painful, red and often comes to a head within a few days. A chalazion is a blocked oil gland that forms a firm, painless lump further from the lash line. Both can make the whole lid swell.
Blepharitis
Blepharitis is ongoing inflammation of the lid margins, with crusting, redness and mild swelling. It often comes with dandruff or rosacea and tends to recur.
Fluid and lifestyle
Salty meals, alcohol, crying, poor sleep, sleeping face-down and hormonal changes cause morning puffiness that settles during the day.
Serious causes
Cellulitis around the eye
- Preseptal cellulitis: infection of the lid skin in front of the eye. The lid is red, swollen and tender, but vision and eye movements are normal. It is more common in children and needs antibiotics.
- Orbital cellulitis: infection behind the orbital septum, often spreading from the sinuses. Warning signs are pain on moving the eye, a bulging eye, double vision, reduced vision and fever. It needs hospital treatment with intravenous antibiotics.
Angioedema
Angioedema is rapid, deep swelling of the lids, lips or face from allergy, ACE inhibitor medicines or hereditary angioedema. Any throat or tongue swelling is an emergency.
Medical conditions
- Kidney disease: nephrotic syndrome causes puffy eyes, especially in children in the morning, with swollen legs and foamy urine.
- Thyroid eye disease: puffy lids, bulging eyes, a staring look and gritty eyes, usually with Graves' disease.
- Underactive thyroid: puffy face and lids with tiredness and weight gain.
Injury
A black eye causes swelling and bruising. Double vision, numbness of the cheek or reduced vision after injury suggests a fracture of the eye socket.
How doctors find the cause
The doctor checks vision, eye movements, pupils and the eye surface, everts the lid, and feels for lumps and tenderness. A CT scan is needed if orbital cellulitis or a fracture is suspected. Urine and blood tests check for kidney and thyroid problems when both lids swell without an eye cause.
Treatment and home care
- Allergy: cool compresses, avoid rubbing, oral antihistamines or antihistamine eye drops.
- Stye or chalazion: warm compresses for 10 to 15 minutes, 3 to 4 times a day, followed by gentle lid massage. Do not squeeze. A chalazion that persists beyond a month can be drained or injected by an eye doctor.
- Blepharitis: daily warm compresses and lid cleaning with diluted baby shampoo or lid wipes.
- Contact dermatitis: stop the suspected product. A doctor may prescribe a mild steroid ointment for a short time.
- Cellulitis: antibiotics, oral for preseptal and intravenous for orbital.
- Morning puffiness: reduce salt and alcohol, sleep with your head slightly raised, and use a cool compress.
Remove contact lenses and avoid eye makeup until the swelling settles.
Frequently asked questions
Why is only one eyelid swollen?
One-sided swelling is most often from a stye, chalazion, insect bite, injury or a local infection. Allergies usually affect both eyes. A single swollen, red, hot lid with fever or pain on moving the eye needs urgent medical attention.
How do I get rid of a swollen eyelid fast?
For allergy or puffiness, use a cool compress and an antihistamine. For a stye or chalazion, use warm compresses several times a day. Avoid rubbing and makeup. If swelling is spreading, painful or affects vision, see a doctor.
Can allergies cause swollen eyelids?
Yes. Allergies are one of the most common causes, especially in spring and with pets or dust. The lids swell and itch, eyes water, and both sides are usually affected. Antihistamine drops and avoiding the trigger help.
When is a swollen eyelid an emergency?
Get emergency care if swelling comes with trouble breathing or swallowing, fever and a red hot lid, pain when moving the eye, a bulging eye, double vision or reduced vision, or after a chemical or penetrating injury.
Why are my eyelids swollen in the morning?
Fluid collects in the lid tissue when you lie flat. Salty food, alcohol, crying, allergies and poor sleep make it worse. If swelling is daily and comes with swollen ankles or foamy urine, see a doctor to check your kidneys.
Sources
This guide was written from current patient and clinical guidance, including:
- American Academy of Ophthalmology: Eyelid swelling; What are chalazia and styes?
- MedlinePlus: Eyelid swelling
- NHS: Swollen eyelid
- American Academy of Allergy, Asthma & Immunology: Eye allergy
- American Academy of Pediatrics: Periorbital and orbital cellulitis