Swollen eyelids result from fluid accumulation or inflammation in the lids. Swelling may be focal or diffuse, painful or painless.
Local and Systemic Causes
Styes, chalazia, blepharitis, and allergic reactions commonly cause local lid swelling. More serious conditions include preseptal or orbital cellulitis, trauma, and angioedema, while systemic fluid retention from kidney or cardiac disease can produce bilateral puffiness.
- Painful, red swelling with fever suggests infection and needs urgent care
- Soft, itchy swelling points towards allergy or contact dermatitis
- Persistent hard lumps may represent chalazia or other lid lesions
- Morning-predominant swelling can reflect fluid shifts or systemic causes
Management
Treatment ranges from cold compresses and antihistamines to antibiotics or surgery, depending on the cause. Assessment is important when vision, eye movement, or general health is affected.
- Orbital cellulitis presents with pain on movement, reduced motility, and systemic illness
- Patients should avoid squeezing or draining lid lumps themselves
- Identifying allergens or irritants prevents recurrent allergic swelling
- Systemic evaluation may be required for recurrent or unexplained oedema
