Common Causes of Swollen Eyelid

Swollen eyelids, either on the top or on the bottom, have many causes. Most are not serious, but they can be caused by medical problems. Eyelids can swell due to allergies, infections, or medical conditions like Graves' disease, a thyroid-related condition that requires long-term treatment.

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 examines the most common causes of swollen eyelids. It offers a few quick tips that may help you care for them and red flags of more serious medical issues to watch for.

Eye Allergies

Eye allergies are the most common cause of eyelid swelling. These allergies may cause discomfort, 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 to protect them. This causes blood vessels inside the eyes to swell, and the eyes become itchy, red, and watery.

Eye Styes and Chalazion

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

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

Pink Eye

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

People with conjunctivitis 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 bacteria, allergies, or viruses cause it. Self-care can begin with warm or cool compresses to soothe the affected eye.

Cellulitis

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

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. It often causes red eyes and pain due to swelling. In most cases, it affects just one eye.

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

COVID-19

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 with skin conditions who experience dry, itchy skin symptoms on the face. Because eczema can affect any area of the skin, it can also 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.

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

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 hypothyroidism (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, the clear dome that covers the front part of the eye, causing inflammation.

Eye herpes, also called ocular herpes, can cause painful sores on the eyelid or the eye surface. The cornea and eyelid are affected. 

Antiviral medications are commonly used to treat eye herpes.

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 severe 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 are essential to prevent complications.

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

Blepharitis

Blepharitis is a common eye condition that causes swollen and crusty eyelids, itchy, watery eyes, sensitivity to light, and dry eyes. It is usually caused by an overgrowth of bacteria on the eyelids.

Preventing and treating blepharitis includes keeping the eyelids clean and free from crusts. Washing with a gentle cleanser such as baby shampoo can help. A healthcare provider can often provide medication for bothersome cases. Blepharitis is difficult to get rid of completely, so maintaining a good hygiene routine is crucial.

When to Call a Healthcare Provider

A swollen eyelid will often resolve in a few days with home care. If the eye continues to be painful or your symptoms worsen, contact your healthcare provider. Depending on the cause, you may be referred to an eye specialist.

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 expected for eyes to look a little swollen when you wake up, 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.