Swollen Eyes

Usually, people do not realize they have an eye disease because many a time, there are no warning symptoms or signs. Some people just assume that a gradual loss of eye function is a natural outcome of growing older. Early identification and treatment of eye problems or symptoms like swelling is the ideal way to have healthy eyesight throughout your life.

What are Swollen Eyes?

Ever wondered why your eyes look swollen or puffy? Your eyes are surrounded by layers of tissues. When these layers are filled with fluid, it causes swelling in the eye. As per ophthalmologists, an eye swelling that lasts longer than 24 to 48 hours can be severely damaging and could blind you. The reasons for eye swelling could be many including stye, chalazion, allergy, traumatic injuries, Graves’ disease or eye cancer. A cool compress or a wash/rinse of your eyes can relieve the swelling, and some cases might need medications and doctor's intervention.

Causes

Swelling on one side of the eye is commonly caused by the following:

• An insect bite
  A reaction to the insect’s saliva after it has bitten near the eye can cause swelling. The loose tissue around the eye swells up easily. Of all insects, you are most likely to be bitten by mosquitoes. (Read more - Insect bite treatment)
• Rubbing the eye
  Rubbing your eye due to any feeling of irritation or otherwise will make your eyelid puffy. Young children often tend to touch their eyes with unclean hands, and some may even get food in the eye.
• Contact dermatitis
  It is a type of eczema produced due to contact with a specific substance.
• Wound
  An injury to or near the eye can cause a bruise and swelling.
• Dacryocystitis
  This is an infection of the tear sac, which is located in the corner of the eye.
• Ethmoid sinus infection
  Infection of the ethmoid sinus which is located behind the eye that causes redness and swelling of the eyelid.
• Periorbital cellulitis
  This happens when the infection from an insect bite or a wound spreads to the eyelids, which then turn red and become painful to touch.
• Black eye
  Swelling and bruising around the eye due to a blow (such as a fall or a punch) to the area.
• Stye
  Also known as a hordeolum, a stye is a small abscess in which pus collects in the oil glands of the eyelashes. When a stye grows, the corner of the eye or the upper or lower eyelid becomes tender, red, and swollen. Once the pus drains out through an opening in the stye, the swelling reduces over a period of days. It usually happens due to Staphylococcus aureus bacteria.
• Chalazion
  Often confused with a stye, it is a bump on the eyelid that can be of varying sizes. A chalazion is formed when the material gets accumulated in the eyelids because of a blocked oil gland.
• Corneal ulcer
  The cornea is the layer that covers the pupil and the iris. A corneal ulcer is an open boil on the cornea. An eye infection or persistent dryness in the eyes can cause a corneal ulcer.

Swelling on both sides of the eye is usually caused by the following

• Graves’ disease
  Also known as Graves’ ophthalmopathy, Graves' disease is a condition that develops in people who have an overactive thyroid. About half the people who have Graves' disease have eye symptoms such as swelling of muscles, tissues and fat in the socket behind the eye. This results in exophthalmos, an unusual protrusion of the eye.
• Allergic conjunctivitis
  Pink itchy eyes resulting from an irritation due to pet dander or pollen.
• Oedema
  A condition in which fluid collects in the tissues of the body is known as oedema. The oedema fluid may also get collected around both the eyes after lying down.
• Viral conjunctivitis
  The main symptom of viral conjunctivitis is redness in the eyes along with the other symptoms of common cold.
• Bacterial conjunctivitis
  The main symptom observed in this infection is a yellow pus discharge in the eye(s).
• Anaphylaxis
  This is a life-threatening allergic reaction. Besides swollen eyes, severe symptoms can manifest which include troubled swallowing or breathing. (Read more - Anaphylactic shock causes and treatment)
• Blepharitis
  Blepharitis is a common eye condition in which the margins of the eyelids become swollen and red. In most cases of blepharitis, both the eyes are affected.
• Orbital cellulitis
  Orbital cellulitis is an inflammation of the soft tissues in the eye. These tissues are located in the eye socket.

Risk Factors

The risk factors for developing a swollen eye are:

• Poor hygiene
  Touching or rubbing your eyes with unclean hands can introduce food particles or irritants in the eye which can result in swollen eyes.
• Proximity to someone with a contagious eye disease
  Being around someone with an infectious eye disease like blepharitis, periorbital cellulitis and conjunctivitis can lead to you contracting it as well. These diseases can result in swollen eyes.

Here are some tips that can keep eyes healthy and prevent swelling and eye diseases:

• For infants, children and teenagers
  Learning about the signs of various eye problems and the recommended vision screenings can help parents to observe signs of eye problems and thus protect their child's eye. If you are a teenager, be aware of the eye issues that may happen at your age, it will help you have excellent eye health for the rest of your life. Make sure to develop healthy practices and learn symptoms of eye problems to have good eye health.
• For young adults
  Young adults should learn about healthy eye habits to have a good eye health for the rest of their life. Although they do not experience eye symptoms like swollen eyes, it is necessary for them to know the risks of developing an eye condition. Getting tested regularly with the suitable vision screening procedures and following healthy eye habits can be helpful to sustain good eye health.
• Adults aged 40 to 60
  Eye diseases and symptoms of various eye diseases mainly begin to appear in this age group. It is vital for adults with no signs or risk factors of eye disease to get a baseline exam. If the baseline exam is conducted soon, it can help in beginning the treatment early. Therefore, this test is recommended at the age of 40 to initiate quick treatment.
• Adults aged over 60
  Irrespective of whether you experience problems with your vision, it is necessary to see your ophthalmologist. Get regular eye tests done, and take measures to protect your vision.

The following diagnostic tests may be advised by your doctor to examine your swollen eye:

• Slit-lamp eye test
  Your ophthalmologist will ask you to be seated in front of a slit lamp. He/she will sit before you and look at your eyes through the microscope. He/she will observe your retina, sclera, cornea, and optic nerve to detect any eye disease and inspect your overall eye health.
• Baseline eye screening
  The American Academy of Ophthalmology recommends adults aged 40, with or without any signs or risk factors of eye disease to go through a baseline examination. It is a screening test to check for the presence of any eye diseases. In general, it is recommended to get regular eye check-ups done to ensure that the eyes are healthy. People who are already suffering from an eye disease or have a reduced vision should ask their ophthalmologist about how frequently they need to get the eye tests done to prevent the advancement of the condition.

The treatment of swollen eyes is based on the underlying cause.

If the swelling in your eyelid is because of a bug bite or is unexplained, the treatment procedure followed is:

• A cold pack will help in relieving the swelling.
• Anti-allergic medications ease the itching and swelling.
• Eyedrops if the swelling does not improve with the cold pack. Over-the-counter medications to control the eye swelling include oral antihistamines, decongestant eye drops, and artificial tears for lubrication.

Your doctor may prescribe you the following medications:

• Anti-allergic medications.
• Non-sedative oral histamines.
• Eye drops that may contain an anti-allergic, antibiotic, corticosteroid, NSAID, or a decongestant.

Treatment of eye swelling based on some of the underlying conditions:

When swelling is due to an underlying disease, treating the disease helps in reducing the swelling as well. Here are some common causes of swelling in eyes and their treatment:

• Graves’ disease
  • Prednisone is an immunity-suppressing steroid medication that reduces the swelling and irritation in the eye.
  • Surgery or radiation therapy may be needed to prevent any further damage to the eye.
  • Sunglasses and eyedrops may also be prescribed to reduce irritation in the eye.
• Chalazion
  • Warm compression of the eyelid for 10 to 15 minutes.
  • Steroid injection.
  • If the chalazion grows bigger, you may need to get it removed surgically.
• Stye
  • Antibiotic ointments to be applied on the affected eye.
  • Surgery in which an incision is made to drain the pus out.
• Conjunctivitis
  • Antibiotic eye drops are specifically useful in bacterial conjunctivitis.
  • Soothing eye drops.
  • Cooling eye pads.

Lifestyle management

What should you do if you observe swelling in your eyes? In most cases, swelling around the eyes goes away within a few days. However, you may follow a few tips that are mentioned below to reduce swelling in the eyes:

• Wash your eyes frequently
  Rinse your eyes with water if you notice a discharge along with the swelling. Use cold water; it is more soothing in the case of allergies.
• Remove contacts lenses
  If you use contact lenses and notice swelling in your eyes or eyelids, instantly remove the lenses.
• Use a cold compress
  Lie down and place an ice-pack or a water-soaked washcloth on your eyes.

If the swelling in your eyes persists longer than 24 to 48 hours with any of the following signs, consult a doctor immediately:

• A sensation that something is stuck inside your eye.
• Pain in the eye(s).
• Decreased vision.
• Seeing floaters (spots in your vision).
• Blurred vision.

Whether you experience swelling in your eyes or not, getting an eye examination done is a good idea to make sure that your eyes have good health for a long time. An eye exam could also disclose signs of some diseases like:

• Diabetes.
• Carotid artery disease (build-up of plaque in the carotid arteries).
• Lymphoma (a type of cancer that begins in the lymphocytes, the cells of the immune system).
• High blood pressure.
• Multiple sclerosis (a condition that affects the central nervous system in which the immune system attacks the covering of the nerve cells).

Prognosis

If the swelling is only on one eyelid with no other signs, it is rarely dangerous. However, an excessive or a sudden swelling of the eyelids of either or both eyes may lead to a serious problem. If there are signs like a loss of vision, inflammation, impaired eye movements or protrusion of the eye, the swelling suggests an orbital disorder that may slightly push the eyeball out and affect the muscles or nerves.

Complications

Swollen eyes can rarely result in complications like sinusitis, blindness and life-threating intracranial sepsis (an infection which enters the bloodstream from an infected sinus and reaches the brain tissues).