What causes a swollen under-eye?

The following images show some of the causes of under-eye swelling or puffy eyes.

Swelling under the eye often causes puffiness, which may lead to the eye partially closing over. Depending on the underlying cause, it may affect one or both eyes.

For some conditions, swelling may occur with other symptoms, such as:

• eye discoloration
• itching
• bruising
• tearing
• discharge

Swelling under one eye may be due to various causes.

Excessive eye rubbing

People sometimes rub their eyes due to fatigue, itchiness, or a foreign object in the eye. According to the Seattle Children’s Hospital, excessive eye rubbing can lead to swelling. Avoiding touching the eyes will allow the area to return to normal.

Injury

Under-eye swelling or puffy eyes may indicate an injury. A cut or bruise may cause swelling, discoloration, and pain. Similarly, insect bites, such as mosquito bites that occur near the eye, may cause swelling.

Small injuries in the eye area may heal on their own if a person keeps the area clean and dry. If the swelling and pain get worse, or there are signs of infection, such as pus or discharge, a person may need medical treatment.

Blocked tear duct

A blocked tear duct prevents tears from draining from the eye and can also cause under-eye swelling. The American Acadamy of Ophthalmology (AAO), lists other symptoms of a blocked tear duct, which include watery eyes and tearing.

Blocked tear ducts can develop due to an eye infection, an injury, or a tumor. If the blockage is the result of an injury, it may resolve on its own. An infection may require antibiotics.

Stye

A stye is an infection that occurs at the base of the eyelashes, causing a painful lump. The AAO indicates that when a person has a stye, they might feel like there is a foreign object in their eye. A person’s eye may also feel scratchy, sensitive to light, or watery.

Styes can clear up on their own. However, if a stye does not improve, a doctor may prescribe antibiotics or may need to drain it.

Periorbital cellulitis

Periorbital cellulitis occurs when a wound near the eye becomes infected. It causes severe under-eye swelling, pain, and inflammation. It is most common in children and is often due to trauma or sinusitis.

This condition requires medical treatment to prevent damage to the eyes and other organs. Treatment may include drainage, surgery to remove dead tissue, and antibiotics.

Lymphoma

Lymphoma is a type of cancer that can affect the eye area in rare cases. According to a 2017 review, a person with lymphoma will experience swelling and a visible lump or tumor. Doctors may treat lymphoma using radiation therapy or chemotherapy.

Swelling under both eyes may have a variety of causes.

Bags under the eyes

A person may notice mild swelling under the eyes when they wake up in the morning. The AAO note that this can occur due to aging, fluid collecting under the eyes during sleep, or both.

Smoking, lack of sleep, fluid retention, and allergies make it more likely that bags will develop under the eyes. Getting enough sleep, sleeping with the head in a slightly elevated position, and cool compresses may help reduce their appearance.

Allergies

Allergens, such as pollen and pet dander, can irritate the eyes, causing an allergic reaction. Symptoms of an allergic reaction include:

• eye swelling
• itching
• burning
• tearing

A person with this condition may also have other allergy symptoms, such as a stuffy nose, sneezing, or an itchy throat.

If swelling in the under-eye area is the result of an allergic reaction, taking an over-the-counter (OTC) allergy medication, such as diphenhydramine (Benadryl) may help reduce the swelling. A person should read the package instructions carefully for proper dosing.

A severe allergic reaction may cause anaphylaxis, which is a medical emergency that causes hives, swollen airways, and difficulty breathing.

Conjunctivitis

Conjunctivitis, or pink eye, occurs as the result of a bacterial or viral eye infection. It causes bloodshot, irritated eyes that may itch, burn, or hurt. A bacterial eye infection may produce white or yellow pus.

Viral conjunctivitis usually affects both eyes, but a bacterial infection may start in one eye and spread to both. Conjunctivitis is contagious, so a person with these symptoms should avoid touching the eyes and see a healthcare professional for treatment.

Morbihan disease

According to a 2017 review, this rare condition can cause severe swelling under the eye and on the upper cheekbones.

Healthcare professionals consider the condition a form of rosacea, which causes the skin on the face to redden or darken. Treatment for Morbihan disease includes steroids and sometimes minor surgery to drain the excess fluid.

Organ failure

A person can experience eye swelling in both eyes due to edema which is the result of organ failure. This includes heart, kidney, or liver failure. Each of these conditions affects the body’s ability to regulate fluid balance, which will often cause swelling in the feet and other areas of the body.

Many causes of swollen under-eyes are temporary or mild. Small bruises or insect bites, styes, and puffy eyes from excessive eye-rubbing may clear up on their own with at-home treatments. Swelling caused by allergies should improve with OTC antihistamines.

However, if there are signs of infection or a more serious injury, such as pain, inflammation, or pus, a person should see their doctor promptly. If a person has any of the following symptoms, they should seek immediate medical attention:

• swelling causes eyes to close partially or completely
• swollen eyes with a fever
• swollen airways or trouble breathing
• vision loss or double vision
• swollen eyes with swollen ankles or feet

In mild cases of under-eye swelling, a person can often reduce the swelling and any eye irritation at home. A person can try:

• Cold compresses or ice: A person can make a cold compress by wrapping ice in a towel or dampening a washcloth and gently pressing to the eye for up to 20 minutes.
• Warm compresses: For styes, a warm compress may be more effective. Soak a clean washcloth in warm water and apply to the eye for 10–15 minutes at a time.
• Nonsteroidal anti-inflammatory drugs (NSAIDs): NSAIDs, such as ibuprofen, may help to ease pain and swelling. If a person has pain and swelling for longer than 7 days, they should seek medical help.
• Eye drops: Hydrating eye drops may reduce symptoms such as dryness, scratchiness, and irritation. Some eye drops also contain ingredients to help people with allergies.
• Eye flush: Flushing the eye with saline may help to clear away any dirt or debris that is irritating the eye.

To prevent the transmission of contagious conditions, the AAO suggests that people should:

• avoid wearing contact lenses and eye makeup
• use clean towels and washcloths
• not share eye products, towels, and washcloths with others
• not touching the eyes, unless necessary

A person can develop under-eye swelling or puffy eyes for a variety of reasons. In many cases, the cause is mild and will improve with OTC medication, cool or warm compresses, and keeping the area clean.

In some cases, a person may need medical attention. If there are signs of infection, such as eye redness, pain, or discharge, or the swelling is severe, a person should see their doctor.