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Puffy eyes, or periorbital edema, refers to swelling around the eyes. The puffiness may occur above the eyes or below, and can have many different causes. Treatment depends on the cause.

When a person has periorbital edema, inflammation around the eye causes fluid to build up. It is this buildup of fluid that gives the eye orbit a puffy appearance. People can have periorbital edema in one or both eyes.

This article explores the various causes and treatments for periorbital edema.

Fast facts on periorbital edema:

  • The term refers to inflammation or puffiness around the eyes.
  • There are many different causes of the condition from health to lifestyle.
  • It is not in itself serious and is usually temporary.
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Puffy eye due to periorbital edema.Share on Pinterest
Periorbital edema may affect one or both eyes.
Image credit: Klaus D. Peter, 2008

Periorbital edema is not the same as having bags under the eyes, which is a natural part of aging. Instead, it is a health condition and is normally temporary.

Numerous different causes may lead to inflammation around the eyes, and they all result in a fluid buildup. It is the fluid buildup that gives the eye orbit a swollen appearance.

For some people, periorbital edema may come on slowly. This type of periorbital edema is described as chronic. For others, it may come on quickly and it is then referred to as acute.

Whatever the cause of periorbital edema, the following treatments may help to reduce swelling:

  • Cutting down salt intake: A salty diet can increase the amount of fluid a person retains. A low-salt diet can help to reduce fluid retention in the body, including around the eyes.
  • Drinking more water: Staying hydrated can help to reduce fluid retention, which can help reduce any fluid buildup around the eyes.
  • Using a cold compress: Cooling the affected areas with a cold compress can help to reduce the inflammation. These are available to purchase online.
  • Corticosteroids: This type of medication can be applied as cream to the skin or taken as a tablet. It helps to reduce inflammation throughout the body, including around the eyes.
  • Anti-inflammatory medication: Medicine such as ibuprofen may be taken orally or applied to the skin. This helps to reduce inflammation throughout the body, including around the eyes.

Other treatments available for periorbital edema are specific to the cause. These include:

  • Antihistamines: These help to reduce swelling around the eyes if it is caused by an allergic reaction.
  • Adrenaline or epinephrine: This emergency treatment helps reduce extreme swelling caused by an anaphylactic shock.
  • Antibiotics: These may help reduce swelling around the eyes if it is caused by an infection.
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Symptoms of periorbital edema may include swelling around the eye, double vision, and being sensitive to the light.

The symptoms of periorbital edema include:

  • mild to severe inflammation around the eye orbit
  • double or blurred vision caused by eye puffiness
  • redness around the eye, alongside swelling
  • bulging of the eyeball
  • the white of the eye appearing inflamed
  • excess tears being produced
  • the eye appearing bruised
  • the eyelids being pushed back by inflammation
  • being sensitive to light
  • pain around the eye or pain when moving the eye
  • itchiness around the eye

Anaphylactic shock

If swelling around the eye is accompanied by other facial swelling or difficulty breathing, this may be anaphylactic shock.

Anaphylactic shock is an extreme allergic reaction and is a medical emergency. A person experiencing anaphylactic shock needs emergency medical treatment.

If a person thinks this may be the case, they should call emergency services without delay.

Acute infection

Periorbital edema may be caused by an acute infection. If a person has an acute infection, they may experience additional symptoms. These include:

  • fever
  • feeling unwell
  • nausea
  • vomiting
  • tender lymph nodes (glands)

Causes can be grouped into the following types:

  • medical
  • natural
  • lifestyle


Medical causes of periorbital edema include:

  • mononucleosis
  • allergic reactions
  • skin disorders
  • thyroid diseases
  • periorbital cellulitis
  • Chagas disease
  • nephrotic syndrome
  • trichinosis
  • problems with tear ducts
  • conjunctivitis
  • eye injury
  • sinusitis


Some things that are a natural part of life may cause swelling around the eyes. These include:

  • Crying: When a person cries, their tears may irritate around the eyes. This may lead to swelling.
  • Aging: As a person ages their body expels more water throughout the day. This can lead to the body trying to retain more fluid, causing swelling around the eyes.


Lifestyle causes of periorbital edema include:

  • Irregular sleep: Getting too much or too little sleep may cause a person’s body to retain fluid.
  • Eating too much salt: Having a diet that is high in salt can make the body retain more fluid.
  • Drinking too much alcohol: Alcohol can cause dehydration. When a person drinks lots of alcohol frequently, it may cause fluid retention.
  • Smoking: Cigarette smoking can cause hormonal imbalances. This may lead to fluid retention.
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A doctor may carry out a blood test to help diagnose periorbital edema.

If a person thinks they may have periorbital edema, they should speak to a doctor. A doctor can help to diagnose the underlying cause.

Tests that a doctor may carry out include:

  • blood tests
  • allergy tests
  • skin biopsy
  • imaging tests

First, the doctor will examine the affected area. Then, they may ask general health and lifestyle questions to establish a cause. Depending on the suspected cause, the doctor may then carry out a series of tests.

Often, home remedies or over-the-counter treatments help to reduce symptoms of periorbital edema.

Sometimes periorbital edema has a more serious underlying cause. A doctor can help to diagnose this and recommend appropriate treatment.

If a person suspects swelling around the eyes is caused by an anaphylactic shock, they should seek emergency medical treatment.