Swollen Eyelid: 9 Common Causes

Swollen eyelids have many causes. Most are not serious, but they can be caused by medical problems. The swelling may be due to allergies or infections that are easily treated. Graves' disease, a thyroid-related condition that requires long-term treatment, may also cause a swollen eyelid. And sometimes, a swollen eye can be related to a severe infection that could lead to loss of vision if it's not treated.

In some cases, a home remedy such as a warm compress may help to resolve the symptoms, but it's often necessary to see a healthcare provider to rule out any serious problems.

This article looks at the most common reasons for swollen eyelids. It also offers a few quick tips that may help you care for a swollen eyelid, as well as red flags of more serious medical issues to watch for.

Common causes of swollen eyelids
Verywell / Brianna Gilmartin.

Eye Allergies

The most common cause of eyelid swelling is eye allergies. Eye allergies may cause discomfort, eyelid irritation, and swelling.

Eye allergy symptoms occur when the immune system overreacts to a substance like dust or pollen. Cells in the eyes release histamines and other chemicals to try and protect the eyes. This causes blood vessels inside the eyes to swell, and the eyes become itchy, red, and watery.

Prescription drugs are very effective at soothing eye allergy symptoms. Antihistamines often quickly reduce eyelid swelling that's caused by allergies.

Eye Styes and Chalazion

A stye is caused by inflammation and infection. It happens when bacteria get into the oil-producing glands in the eyelid. Styes can feel itchy and tender. They usually look like a reddish bump on the eyelid. When a stye first starts, the eye may feel sensitive to light and can look a little bruised.

A chalazion is what happens when one of these glands gets blocked. The gland turns into a hard lump, which may cause redness and swelling of the eyelid.

If you have a stye, try to put a warm, wet compress on it for five to 10 minutes a few times a day. This often makes the eye feel better, and may also help to open any blocked pores. The stye can then drain out and start to heal.

Pink Eye

Pink eye or conjunctivitis is an inflammation of the conjunctiva. The conjunctiva is a clear membrane that lines the inside of the eyelid and covers the white part of the eye. Pink eye usually is caused by allergies, bacteria, or viruses.

People with conjuctivitis may wake up to find one or both eyes stuck together with mucus. The eyelids may be swollen, and the eyes may be red, itchy, and irritated.

Treatment will depend on the underlying cause of pink eye. Your healthcare provider can help determine whether it's caused by bacteria, allergies, or a virus. Self-care can begin with either warm or cool compresses to soothe the affected eye.

Cellulitis

Cellulitis is a more serious cause of eyelid swelling, and this condition is a medical emergency that requires prompt treatment. It is a bacterial infection of the lower layers of the skin.

There are two main types;

  • Orbital cellulitis is linked with a sinus infection. The infection spreads into the area around the bones that make up the eye socket. People with orbital cellulitis may have a bulging eye, and pain when moving their eyes back and forth.
  • Preseptal cellulitis is an infection of the eyelid and/or surrounding skin. People often have red eyes, along with pain due to swelling. In most cases, it will affect just one eye.

One study of 80 people with eye-related complications of sinusitis found more than half (52.9%) were caused by orbital cellulitis while 29.4% were due to preseptal cellulitis. Treatment included antimicrobial drugs.

COVID-19

A condition called endophthalmitis, a type of eye inflammation that can lead to swollen eyelids, has been comparatively rare in the past. It is usually associated with infection, especially after surgery, or with eye trauma.

But since the COVID-19 pandemic, there's been a rise in endophthalmitis cases. Complications of endophthalmitis include a loss of vision. Treatment includes antifungal and systemic antimicrobial therapies.

While you may have a less serious case of swollen eyes as a symptom of COVID, early detection and treatment are important in order to avoid the most serious impacts.

Eczema

Eyelid eczema is common in people living with the skin condition who experience dry, itchy skin symptoms on the face. Because eczema can affect any area of skin, it also can affect the eyelid.

Similar conditions, including contact allergies, can affect the eyelid, too. Cosmetics, including nail polish, can cause an allergic reaction that leads to a swollen eyelid. Careful handwashing can help prevent a reaction to contact lens solutions and other products used around the eyes.

Medications called topical calcineurin inhibitors (TCIs) or, in some cases, steroids may be used to treat eyelid eczema.

Graves' Disease

People with Graves' disease or other thyroid problems often develop eyelid swelling. Graves' disease can cause the eyes to bulge. Although it can affect one eye more than the other, it usually involves both eyes.

Sometimes Graves' disease can limit eye motion or cause double vision. Any type of hypothyroidism, or low levels of thyroid hormones, can cause both eyes to seem swollen or puffy.

Your healthcare provider may prescribe steroids, like prednisone, or Tepezza (teprotumumab) to help treat your swelling. Some cases may be treated with radiation to reduce swelling in the eyes' muscles and tissues.

Herpes Infection

It is not uncommon for herpes to become an eye disease. The herpes virus can infect the cornea, causing inflammation. This is the clear dome that covers the front part of your eye.

Eye herpes, also called ocular herpes, can cause painful sores on the eyelid or the eye surface itself. The cornea is affected as well as the eyelid. 

Antiviral medications are commonly used to treat eye herpes.

Symptoms of eye herpes often seem the same as symptoms of pink eye.

Shingles

Shingles, also called herpes zoster, is caused by a viral infection related to chickenpox. A shingles rash can affect the face and eye, with swollen eyelids as a symptom. The ophthalmic (eye) form of shingles can lead to serious complications, including vision loss in rare cases.

People who are older, or who have weakened immune systems because of chemotherapy treatment, human immunodeficiency virus (HIV), and other causes, may be more at risk of a shingles infection that affects the eye. Early detection and treatment is important to prevent complications.

Antiviral medications and steroid eye drops may be prescribed to treat a shingles-related infection.

The herpes virus also can affect the eye, but it is not the same virus that causes shingles.

When to Call a Healthcare Provider

In many cases, a swollen eyelid will resolve in a few days with home care. If the eye continues to be painful or your symptoms get worse, be sure to contact your healthcare provider. It's possible that you may be referred to an eye specialist, depending on the cause.

Some symptoms may point to a more serious condition. You should contact a healthcare provider right away if you experience:

  • A swollen eyelid that is red and feels hot
  • A blistered eyelid
  • Changes in your vision
  • A sudden eyelid droop
  • Eye pain

Summary

It could be normal for eyes to look a little swollen when you wake up in the morning, but severe eye swelling is not. The most common causes of new eyelid swelling include allergies, pink eye, and styes, but skin infections, thyroid disease, and herpes are other possible causes.

Frequently Asked Questions

  • Why are my eyelids puffy in the morning?

    Waking up with puffy eyelids—known as eyelid edema—occurs because of fluid retention. During sleep, the body’s heart rate and blood pressure slow down. As a result, less blood circulates, which can lead to eyelid edema in the morning. It resolves quickly once you are awake.

  • What causes under-eye swelling?

    Swelling under your eye—commonly known as bags under your eyes—can be caused by:

    • Age
    • Allergies
    • Fluid retention
    • Heredity
    • Lack of sleep
    • Smoking

    Other causes of under-eye swelling include cellulitis, conjunctivitis, and herpes infection of the eye. 

  • How do you treat a swollen eyelid?

    It depends on the cause. A cool eye compress can help to reduce eyelid edema. A warm compress can help eyelid swelling from a stye or chalazion. If allergies are causing eyelid swelling, antihistamines like Benadryl or eye drops can help to reduce swelling.

8 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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  3. Khatwani PR, Goel NP, Trivedi KY, Aggarwal SV. Unveiling endophthalmitis post COVID-19 - A case series. Indian J Ophthalmol. 2021 Oct;69(10):2869-2871. doi:10.4103/ijo.IJO_1616_21.

  4. National Eczema Society. Eczema Around the Eyes.

  5. National Eye Institute. Graves' eye disease.

  6. Iancu GM, Stănilă DM, Cipăian RC, Rotaru M. Ophthalmic herpes zoster with severe complications in an immunocompromised patient: A case report and review of the literature. Exp Ther Med. 2022 Mar;23(3):214. doi:10.3892/etm.2022.11138. 

  7. National Health Service. Eyelid problems.

  8. American Academy of Ophthalmology. Bags under the eyes.

By Troy Bedinghaus, OD
Troy L. Bedinghaus, OD, board-certified optometric physician, owns Lakewood Family Eye Care in Florida. He is an active member of the American Optometric Association.