Some Causes and Features of Eyelid Swelling
Some Causes and Features of Eyelid Swelling
Cause |
Common Features* |
Diagnostic Approach† |
Eyelid disorders |
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Allergic reaction affecting only the eyes |
Itching but no pain Pale, puffy eyelid or eyelids and sometimes pale, puffy conjunctiva (the membrane that lines the eyelids and covers the front of the eye) Sometimes in people who have had a previous episode, been exposed to an allergen, or both Affecting one or both eyelids |
A doctor's examination alone |
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Blepharitis (inflammation of the edges of the eyelids) |
Yellow crusts on lashes Eye itching, burning, redness, sores, or a combination Sometimes accompanied by seborrheic dermatitis (inflammation of the skin characterized by greasy scales on the scalp and face) Usually affecting both eyelids |
A doctor's examination alone |
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Blepharitis caused by herpes simplex virus |
Clusters of fluid-filled blisters on reddened skin, open sores, and significant pain Usually affecting only one eye (may affect both eyes in children) |
A doctor's examination alone |
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Chalazion (enlargement of an oil gland deep in the eyelid) |
An area of redness and pain on only one eyelid Eventually development of a round, painless swelling away from the edge of the eyelid |
A doctor's examination alone |
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Conjunctivitis, infectious (pink eye, or inflammation of the conjunctiva, caused by bacteria or a virus) |
Redness of the white of the eyes, a discharge, and sometimes crusts on the lashes when the person wakes up Affecting one or both eyes |
A doctor's examination alone |
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Clusters of fluid-filled blisters on reddened skin, open sores, and significant pain Usually affecting only one eye with skin rash adjacent |
A doctor's examination alone |
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Stye (hordeolum) |
Redness and pain affecting one eyelid Eventually swelling at the edge of the eyelid, sometimes with a small, raised, pus-filled bump |
A doctor's examination alone |
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Insect bite |
Itching, redness, and sometimes a small, raised bump |
A doctor's examination alone |
Disorders in and around the orbit |
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Cavernous sinus thrombosis (blockage of a vein at the base of the brain by an infected blood clot)‡ |
Headache, bulging eyes, weak eye muscles with double vision, a drooping eyelid, loss of vision, and fever Usually affecting one eyelid first, then the other eyelid Symptoms of sinusitis (pain behind the eyes or in the face that worsens when the head is moved and nasal discharge, sometimes with bleeding) or other infections of the face, such as orbital or preseptal cellulitis |
CT or MRI of the brain and orbits done immediately |
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Orbital cellulitis (infection of tissue within and around the eye socket, or orbit)‡ |
Bulging of the eye, eye redness, pain deep within the eye Red, swollen eyelids Sometimes double vision, inability to move the eye in certain directions, pain with eye movement, or loss of vision Usually affecting only one eye Fever Sometimes preceded by symptoms of sinusitis |
CT or MRI of the orbits |
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Preseptal (periorbital) cellulitis (infection of the eyelid and the skin and tissues around the front of the eye) |
Swelling and redness around the eye but not bulging of the eye Sometimes pain (usually around the eye) and fever Usually affecting only one eye Normal vision and eye movement Sometimes preceded by a skin infection near the eye |
A doctor's examination Sometimes CT or MRI of the orbits |
Disorders that affect the entire body§ |
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Allergic reactions |
Itching Sometimes allergy symptoms that involve other areas (such as hives, wheezing, or a runny nose) Sometimes in people who have had a previous allergic episode, who have been exposed to an allergen, who tend to have many allergies, or a combination Usually affecting both eyes |
A doctor's examination alone |
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Disorders that cause swelling throughout the body (such as chronic kidney disease, heart failure, liver failure, and, in pregnant women, preeclampsia) |
Swelling of both eyelids and sometimes the forehead No itching, pain, redness, or other symptoms affecting the eyes Usually swelling of the feet |
Testing for heart, liver, or kidney disorders, depending on which disorder is suspected |
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Hypothyroidism (an underactive thyroid gland) |
A puffy face but no pain Dry, scaly skin and coarse hair Inability to tolerate cold |
Blood tests to evaluate thyroid gland function |
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Graves disease (an overactive thyroid gland caused by an immune problem) |
Bulging eyes, double vision Generally not painful Fast heart rate, anxiety, weight loss |
Blood tests to evaluate thyroid gland function CT or MRI of the orbits if bulging is severe |
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* Features include symptoms and the results of the doctor's examination. Features mentioned are typical but not always present. † Although a doctor's examination is always done, it is mentioned in this column only if the diagnosis can sometimes be made only by the doctor's examination alone, without any testing. ‡ These disorders are rare. § These disorders cause swelling in both eyelids and do not cause redness. CT = computed tomography; MRI = magnetic resonance imaging. |
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