What do puffy eyes mean?

When do puffy eyes need urgent help?

Get emergency medical help if swelling comes with difficulty breathing or swallowing, or a feeling that your throat is closing. Facial swelling can be part of anaphylaxis, a severe allergic reaction.3

Seek urgent medical or eye care if:

• Your eyelid is red, hot, painful, tender or blistered.
• You have pain inside the eye, sensitivity to light or changes in vision.
• You cannot open your eye, keep it open or close it completely.
• Your eyelid suddenly droops, or the white of your eye becomes very red.
• Eye symptoms come with a headache, nausea, vomiting, fever or feeling generally unwell.

What can the pattern of swelling tell you?

Mild morning puffiness that fades within a few hours can reflect normal overnight fluid retention. Too much or too little sleep can make facial swelling more noticeable. Salt also encourages water retention. After crying, fluid collects around the eyes; puffiness can settle within minutes or remain the next morning.135

Other symptoms help narrow the possibilities, but they are not enough to diagnose the cause yourself.

Blepharitis means inflammation of the eyelids and can cause burning, redness and crusty eyelashes. Conjunctivitis affects the tissue covering the eye and lining the eyelids. If the eye surface itself looks swollen or blisterlike, rather than just the surrounding skin, that can be chemosis, swelling often associated with allergy or infection.47

Longstanding bags under the eyes can reflect inherited fat pads, bone structure or loose skin rather than a new episode of swelling. Persistent eyelid swelling can also accompany conditions such as thyroid eye disease. Unexplained facial swelling deserves assessment, particularly after a new medication. During pregnancy, facial swelling can be associated with preeclampsia, a condition involving high blood pressure.136

What can you do for mild puffiness?

A cold washcloth can help reduce puffiness, giving the most ordinary item in the bathroom a rare lead role.1

For mild swelling without urgent warning signs:

1. 1Remove contact lenses immediately if your eyes or eyelids are swollen.
2. 2Place a cool, damp washcloth over closed eyes for a few minutes. Wrap frozen packs in a towel rather than placing them directly on skin.
3. 3Keep your head slightly raised when resting or sleeping to reduce fluid buildup.
4. 4If you suspect mascara, eyeshadow or eye cream is irritating the area, stop those products for at least a couple of weeks and watch for improvement.

A cold compress is a home option for temporary puffiness, so an elaborate eye care purchase is not a prerequisite. Avoid testing a new product on the sensitive eye area while it is swollen. Use antihistamine eye drops only for allergies, and steroid eye drops only as prescribed. Do not use hemorrhoid cream around your eyes; it can irritate or damage them.15

How long should you wait?

Temporary eyelid puffiness often settles within a day. Arrange an eye care appointment if swelling lasts longer than 24 to 48 hours, and seek help sooner if it worsens or develops warning signs. A pharmacist can help with common eyelid problems and advise whether you need an optician or doctor. Treatment depends on the cause: infections, allergies and blocked glands do not all need the same approach.127