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

When a person has periorbital edema, inflammation around the eye causes fluid to build up. This buildup of fluid 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.

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 causes may lead to inflammation around the eyes, resulting 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 chronic. For others, it may come on quickly, and doctors refer to this as acute.

Below are some possible causes of periorbital edema.

Allergic reactions

Allergic reactions can cause skin inflammation around the eyes, and red and watery eyes.

In this case, taking antihistamines may reduce the symptoms.

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.


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.

Acute infection

An acute infection may cause periorbital edema. If a person has an acute infection, they may experience additional symptoms. These include:

Conjunctivitis or periorbital cellulitis

Conjunctivitis, or pinkeye, is when the thin membrane covering the eye becomes inflamed.

The eye can appear red or pink, swollen, and irritated. This could be due to an infection or irritation.

Causes include viruses or bacteria, and conjunctivitis can be highly contagious. Treatment will depend on the cause but may include antibiotics.

A similar infection, periorbital cellulitis, affects the skin around the eyes and the eyelid, which can also cause periorbital edema.


When a person cries, their tears may irritate around the eyes. This may lead to swelling.

Diet and lifestyle

Lifestyle causes of periorbital edema include:

  • not getting regular sleep
  • having a diet that is high in salt
  • drinking a lot of alcohol frequently, as this can cause dehydration

These lifestyle changes may cause a person’s body to retain fluid.

Eye injury

Injuries to the eye or eye area, such as a black eye, may cause swelling and bruising.

Thyroid diseases

Autoimmune thyroid disease may cause eye problems such as impaired vision and periorbital edema.

It is more common in Graves’ disease but can also occur in people with hypothyroidism.

Other causes

Other possible causes of periorbital edema include:

Symptoms associated with 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
  • the white of the eye appearing inflamed
  • producing excess tears
  • the eye appearing bruised
  • inflammation pushing the eyelids back
  • being sensitive to light
  • pain around the eye or pain when moving the eye
  • itchiness around the eye

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

  • Cutting down salt intake: A salty diet can increase the amount of fluid a person retains. A low salt diet can help reduce fluid retention in the body, including around the eyes.
  • Drinking more water: Staying hydrated can help reduce fluid retention, which may reduce fluid buildup around the eyes.
  • Using a cold compress: Cooling the affected areas with a cold compress may reduce the inflammation.
  • Corticosteroids: A person can apply this medication as a cream to the skin. It helps reduce skin inflammation, including around the eyes.
  • Anti-inflammatory medication: A person may take medication such as ibuprofen. This may 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 reduce swelling around the eyes if an allergic reaction causes it.
  • Adrenaline or epinephrine: This emergency treatment helps reduce extreme swelling caused by an anaphylactic shock.
  • Antibiotics: These may reduce swelling around the eyes if an infection causes it.

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

Tests that a doctor may carry out include:

The doctor will examine the affected area. They may also ask general health and lifestyle questions to establish a cause. Depending on the suspected cause, the doctor may carry out a series of tests.

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

However, periorbital edema can have a more serious underlying cause in some cases. A doctor can help diagnose this and recommend appropriate treatment.

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