Brief overview
- Causes: e.g. short night with a lot of alcohol consumption, a lot of computer work, dry air, colds, allergies, eye diseases (styes, chalazion, conjunctivitis, tumors in the eye area, etc.), heart failure, kidney failure
- What to do with swollen eyes? For harmless causes, cool the eye area, drink plenty of fluids, use special care products if necessary, possibly gentle eye massage
- When to see a doctor? If no cause can be identified and/or the eyes are also painful, watery, red or vision is deteriorating
- Diagnosis: doctor-patient consultation to take a medical history, ophthalmological examination, smear test, possibly tissue sample, further examinations depending on the suspected cause
- Treatment: depending on the underlying disease, e.g. with antibiotics for bacterial eye infections
Swollen eyes: causes and possible diseases
Allergies, colds or heavy, prolonged crying often cause the eye area to swell temporarily. However, the fluid deposits that cause the tissue around the eyes (and possibly other parts of the body) to become thick can also be caused by other illnesses. The main causes of swollen eyes are
Eye diseases
- Hailstone (chalazion): In contrast to sty, chalazion only occurs on the upper eyelid when the ducts of the meibomian glands located here become blocked. In this case, the eyelid swelling is painless.
- Tumor in the eye area: What sometimes looks like a chalazion is actually a malignant tumor of the eyelid glands. This can also cause swollen eyes.
- Conjunctivitis: This can be viral, bacterial, allergic or mechanical (caused by foreign bodies). Signs include a swollen eyelid, swollen conjunctiva, a red, watery and (in the morning) sticky eye, photophobia and sensitivity to glare as well as a feeling of pressure or a foreign body in the eye. Depending on the cause, the inflammation may only affect one eye or both eyes. The bacterial form in particular is contagious and can quickly spread through the family via contaminated towels.
- Orbitaphlegmons: This is a bacterial inflammation of the entire eye socket, which is often the result of an infected sty or sinusitis. It must be treated as quickly as possible, otherwise there is a risk of blindness. A severely swollen eyelid, pain, fever, reddened conjunctiva and a protruding eye can be the first signs of orbital phlegmon.
Other diseases
- Quincke’s edema (angioedema): This is an acute, painless swelling of the skin and/or mucous membranes. It can occur anywhere on the body, including the face: the eyes, chin, cheeks and lips are particularly affected, along with the mucous membranes. The swelling can be associated with an unpleasant feeling of tightness. Quincke’s oedema is very often caused by allergies.
- Kidney failure: If the kidneys no longer work properly, water retention (oedema) occurs throughout the body. In addition to the legs, the face can also swell. Those affected excrete less urine and also experience non-specific symptoms such as difficulty concentrating and rapid fatigue.
- Heart failure: Chronic heart failure (cardiac insufficiency) leads to edema (water retention) in the legs, abdomen and face due to reduced pumping capacity of the heart.
- Runny nose: Sometimes thick eyes are the result of a simple cold.
- Inflammation of the paranasal sinuses (sinusitis): Sinusitis can also cause palpable swelling of the cheeks and/or swelling of the eyes.
- Cluster headaches: People with cluster headaches are often woken from sleep at night by severe pain around one eye. The pain attacks last up to three hours. The eye tears and swells. Conjunctivitis (inflammation of the conjunctiva) or a drooping eyelid is also possible.
Other causes of swollen eyes
- Dry eyes: Contact lenses and working at the computer dry out the eyes and cause swollen eyes, especially in the evening. In winter, warm, dry heating air can also cause discomfort in the eyes.
- Crying: Crying increases the pressure in the eye area, which acts on the surrounding tissue. This squeezes fluid out of the fine blood vessels, particularly in the delicate area of the lower eyelid, resulting in swollen eyes.
- Heredity and age: Large bags under the eyes are often due to a family predisposition. In addition, the tissue becomes increasingly slack with age, which also favors puffy eyes and bags under the eyes.
- Disturbed lymph drainage during sleep: The flat position when lying down makes lymph drainage more difficult, which can cause the eyes to be swollen in the morning.
- Diet and alcohol: If you eat a meal high in protein or salt in the evening or drink a lot of alcohol, you often wake up the next day with swollen eyes (due to accumulated lymph fluid).
- Blow to the eye: The well-known “black eye” as a result of a blow or bump to the eye area occurs when the injured vessels bleed into the tissue around the eyeball. A swelling is typical here; later this becomes discolored like a bruise.
Anyone who has received a blow or substance to the eye should always see an ophthalmologist. Bones in the eye area could be broken and/or the eyeball injured!
Puffy eyes: what you can do yourself
To eliminate or prevent puffy, small eyes, which are almost certainly not due to an underlying (serious) illness, you don’t have to go to the doctor straight away. You can try the following home remedies and tricks first:
- Drink enough: A truism – but one that is true. Sufficient fluid intake (preferably in the form of water) helps to stimulate lymph transport and prevent swelling around the eyes.
- Cooling: Place a spoon or cooling goggles in the fridge overnight and place them gently on the swollen eye for about ten minutes. This is good and helps to reduce swelling.
- Cucumber on the eyes: Freshly cut cucumber slices on the eyes are tried and tested. They not only have a cooling effect, but also moisturize the skin.
- Massage: In combination with care products for the sensitive eye area, you can gently massage your eyelids – either with circular movements around the eyes or by lightly tapping from the root of the nose along the lower eyelid.
- Lymphatic drainage: This can reduce puffiness. To do this, close your eyes and gently stroke five times with your fingertips from the root of the nose over the upper and lower eyelids towards the temples. This should stimulate the lymph flow and help to remove waste products. Even better: leave the lymphatic drainage to an expert (e.g. physiotherapist).
- Sleep with your head slightly elevated: Lymphatic drainage is more difficult when lying down, which can result in swollen eyes in the morning. Sleeping with your head slightly elevated can help – or simply be patient: Unlike real “bags under the eyes”, which are caused by fat deposits in the lower eyelid and the underlying tissue and are caused by age or genetics, these oedemas drain on their own within hours with the help of gravity. They are therefore only a temporary aesthetic problem.
- Hemorrhoid ointment: A thin layer of hemorrhoid ointment on the eyelids can reduce the swelling of swollen eyes. The ointment causes the blood vessels to contract. However, do not use products that contain cortisone and local anesthetics! Products containing horse chestnut extracts are more suitable: this medicinal plant has a natural decongestant effect. When applying, make sure that no ointment gets into the eye!
Many experts take a critical view of the use of hemorrhoid ointment for swollen eyes and advise against it.
Home remedies have their limits. If the symptoms persist over a longer period of time, do not improve or even get worse, you should always consult a doctor.
Swollen eyes: when to see a doctor?
Swollen eyes as a result of too little sleep, a night of partying or excessive crying are harmless. A visit to the doctor is not necessary. Instead, you can use home remedies to help the swelling to subside more quickly (see above: “What you can do yourself”).
See a doctor (ophthalmologist) immediately if your eyes are not only swollen, but also painful, watery, very red and/or sensitive. There may be a bacterial infection behind it, which should be treated urgently – not only because of the risk of infection for others, but also because of the risk of (permanent) damage to the eye.
You should also see an ophthalmologist as soon as possible if you notice a decrease in vision in addition to the swelling in the eye area!
Swollen eyes: examinations
First of all, the doctor will ask you about your medical history (anamnesis): Among other things, he will ask you to describe the symptoms in detail, ask how long they have been present and whether you have any known underlying illnesses (e.g. allergies, thyroid, heart or kidney disease).
The ophthalmologist can then carry out an ophthalmologic examination. This will determine whether an eye disease is responsible for the swollen eyes. High blood pressure or diabetes can also cause pathological changes in the eye area.
A swab of the eye secretion can be examined for pathogens.
Depending on the suspected cause of the eye swelling, further examinations may be useful, for example cardiac ultrasound and ECG if heart disease is suspected.
Swollen eyes: treatment
If swollen eyes have a cause that requires treatment, the doctor will initiate appropriate therapeutic measures. Some examples:
If swollen eyes are the result of a bacterial inflammation (as with styes), the doctor will often prescribe local antibiotic preparations. Patients should also pay attention to absolute hygiene and cleanliness – the pathogens can quickly spread to other people through dirty hands or shared towels.
A sty is less dangerous. It rarely needs to be opened by an ophthalmologist so that the pus can drain away. However, never try to express a sty yourself! Otherwise you may inadvertently introduce the germs into the healthy eye, which will then also become inflamed.
If you have general illnesses such as a weak heart or kidneys, these must be treated specifically. The swollen eyes and other symptoms of the disease will then usually disappear.
