OPHTHALMOLOGY

Q:I often wake up with puffy eyelids that usually get better within a few hours. What causes this to occur? Is there any treatment?

A:Puffy or swollen eyelids can occur for many reasons including eye fatigue, stress, allergies, age, eye injury or trauma, medical conditions, and individual or familial skin characteristics. When puffiness occurs around the eyelids, it indicates an accumulation of fluids in the surrounding skin tissues. The skin around the eye is the thinnest in the body so swelling and puffiness can appear very prominent and noticeable. One of the reasons that puffiness often occurs more in the morning is because we do not blink while sleeping which allows fluid to accumulate in the eyelids. When we awaken and our eyelids begin blinking and our circulation resumes its normal flow, the swelling and puffiness around the eyes will often dissipate.

Other factors that contribute to an accumulation of fluid around the eyes include excess intake of salt, allergies to the environment or medication, sinus issues, dehydration, fatigue and lack of sleep, stress, crying, and aging.

There are also certain medical conditions that can also cause swollen, puffy eyelids including thyroid disease, conjunctivitis (pink eye), eye infections, severe dry eye, styes, and some systemic conditions such as kidney failure that can cause general swelling throughout the body.

If the puffiness and swelling you experience subsides or is infrequent, things like artificial tears throughout the day or cool compresses over closed eyelids can help to soothe and comfort the eye. It is also helpful to avoid rubbing your eyes and you may want to discontinue contact lens use until swelling subsides for comfort. Other proactive measures that you can take to reduce eyelid puffiness include keeping hydrated, getting ample sleep and rest, and reducing salt intake.

If however there is increased or sustained inflammation of the eyelids that does not go away, other eye irritation, eye pain or symptoms, see your eye doctor to help identify the underlying cause and if medical treatment is needed. It is also important to followup with your eye doctor to monitor and care for your symptoms over time as needed.