What Can Cause a Swollen Eyelid?

Patients generally present with a swollen eyelid due to allergy, infection, fluid accumulation, or sometimes severe eye injuries.

Individuals with swollen eyelids may also have puffy eyes, abnormal redness, and swelling of the eye and eyelids. If the patient has an infection, they might also present with fever. An individual may or may not complain of pain. Some serious cases of eyelid swelling can threaten the vision of the eye if medical attention is not provided. 

Patients generally present with a swollen eyelid due to allergy, infection, fluid accumulation, or sometimes severe eye injuries. Below are a few important conditions, which can usually cause a swollen eyelid:

Preseptal cellulitis: 

• It is an infection of the outer side of the eyelid. 
• Children and young adults are more affected by this.
• Patients present with swelling, pain, and redness of the eye with generalized body fever. 
• Recurrent preseptal cellulitis is possibly due to an underlying cause that has not been diagnosed or treated.

Orbital cellulitis: 

• It is an infection of the eyelid.  
• Children and young adults are more affected by this.
• Symptoms include swelling, pain, and redness of the eye with generalized body fever, abnormal displacement of the eye (proptosis), eye irritation with water oozing (chemosis), and decreased vision and paralysis of muscles within or surrounding the eye (ophthalmoplegia).
• It is a serious condition that can rapidly lead to dangerous complications and require urgent treatment. 

Acute dacryocystitis:

• It is an infection that obstructs the tears from flowing into the nose. 
• Often occurs in infants.
• The patient experiences abnormal redness (erythema), swelling, warmth, and pain/discomfort (tenderness) with or without pus discharge. 
• It is a medically urgent condition owing to the possibility of serious complications.

Stye (external hordeolum):

• It is a bacterial infection seen on the margin of the eyelid. 
• The patient experiences pus and swelling of the eyelid margin affecting the eyelashes and tear glands. 
• The typical presentation is a sudden and severe onset of a red, painful, swollen boil (furuncle), which usually resolves on its own but sometimes leaves a scar or a hard lump (hard chalazion). 

Allergic contact dermatitis:

• It is a delayed allergic reaction by the body’s immune system (T-cell-mediated, delayed-type hypersensitivity reaction) due to external allergens (paints, metals, flowers, etc.) in sensitive individuals.
• This is more common in adults. 
• The patient presents abnormal redness with patches and swelling of the skin. Sometimes fluid-filled boils are also seen with the patches. 
• Affected skin or wounds are commonly seen in the area of exposure to the allergen, most frequently on eyelids.

Eyelid swelling usually resolves on its own within a day or two. Initially, individuals can gently wash the eye and apply a cold or hot compress to it. Getting sufficient rest is usually advised in these cases. Pain can be treated with over-the-counter medications but if the swelling does not resolve, it is advised to approach a doctor for further treatment. 

To treat a swollen eyelid, the doctor usually recommends:

• Common antibiotic regimens include clindamycin, amoxicillin, cefpodoxime, or cefdinir. 
• In adults as well as in children older than 1 year, outpatient treatment with a 7- to 10-day course of oral antibiotics may be initiated with close follow-up. If there is no response within 24-48 hours, therapy might be switched to intravenous antibiotics and the patient should be monitored.
• Children younger than 1 year, patients with impaired immunity, and those with evidence of toxicity or more severe infection should be admitted to the hospital for administration of intravenous antibiotics. Once improvement is noted, treatment can be switched to oral antibiotics with further monitoring.