Swelling Under One Eye: Causes, Treatment, Red Flags

Swelling under one eye can affect an eyelid, nearby skin, eyebrow, or cheek ^5,6. It may occur with redness, itching, pain, bruising, tearing, or discharge ^3,6.

The cause can range from rubbing or allergies to injuries and serious infections [3-6]. This guide explains the symptoms and causes of swelling under one eye, available treatments, and when to seek care.

Mild morning puffiness may develop when fluid collects beneath the eyes during sleep ⁶. Aging can also weaken nearby tissue and allow fat to bulge outward.

Other patterns require closer attention. Painful eye movement, bulging, double vision, and reduced vision can occur with orbital cellulitis ⁵. Orbital cellulitis is a medical emergency involving tissues inside the eye socket ⁵.

One swollen eye may look puffy, red, bruised, discolored, or partly closed ^3,5,6. The swelling may involve the upper lid, lower lid, eyebrow, or upper cheek ^5,6.

The location and other symptoms can provide helpful clues. A painful lump near the eyelashes can occur with a stye ⁶. A watery eye may occur when a tear duct becomes blocked ⁶.

Swollen and red eyelid edges can occur with inflamed meibomian glands ¹. These small eyelid glands release oil onto the eye’s surface ¹.

An injury can cause swelling, pain, bruising, or changes in skin color ^3,6. An insect bite near the eye can also cause local swelling ⁶.

Eye bags often relate to aging, allergies, fluid retention, or inherited facial features. A high-salt diet can also lead to fluid retention and swelling.

Under-eye bags do not usually affect health or vision. Cold compresses can temporarily reduce this type of puffiness.

A one-sided lump, painful rash, discharge, or marked redness fits other conditions ^2,6,10. These signs may require assessment based on their cause and severity.

The appearance of swelling under one eye can vary widely. Under-eye puffiness may partly close the affected eye ⁶.

Symptoms that can occur with a one swollen eye include:

A tender lump at the base of an eyelash fits the pattern of a stye ⁶. The eye may also feel scratchy, watery, or sensitive to light ⁶.

Meibomian gland inflammation may cause repeated styes and swollen eyelid edges ¹. Excess oil in tears can also cause slight blurring ¹. This type of blurred vision often clears after blinking ¹.

A blocked tear duct keeps tears from draining normally ⁶. It can cause one watery eye, repeated tearing, and under-eye swelling ⁶.

Conjunctivitis can make an eye bloodshot, irritated, itchy, painful, or watery ⁶. White or yellow pus may occur with bacterial conjunctivitis ⁶.

A bacterial infection may begin in one eye before spreading to both ⁶. Viral conjunctivitis commonly affects both eyes ⁶.

Some symptoms can point toward infection inside the eye socket. Watch for the following warning signs:

Repeated rubbing can cause swelling around one eye ⁶. It often happens because of itching, tiredness, or a foreign object ⁶.

Pollen and pet dander can cause an allergic eye reaction ⁶. Symptoms can include swelling, itching, burning, and tearing ⁶.

An allergy may also cause sneezing, nasal congestion, or an itchy throat ⁶. Trouble breathing with facial or mouth swelling can signal a severe allergic reaction ⁶. If trouble breathing or facial or mouth swelling occurs, call emergency services now and seek immediate medical help ⁶.

A stye is an infection at the base of an eyelash ⁶. It causes a painful lump and may create a scratchy feeling ⁶.

The affected eye may feel watery or sensitive to light ⁶. Some styes clear without medical treatment ⁶. A persistent stye may need prescribed antibiotics or drainage ⁶.

Meibomianitis means inflammation of the oil glands along the eyelids ¹. These glands release oils that support the normal tear film ¹.

Blocked glands can reduce the oil available for tears ¹. This problem can lead to dry-eye symptoms ¹.

Common signs of meibomian gland inflammation include:

Blepharitis means inflammation along the eyelid edge. Meibomian gland inflammation involves oil-releasing glands in the eyelids ¹.

Allergies and hormone changes can contribute to meibomian gland problems ¹. Acne and rosacea can also contribute to these problems ¹. Rosacea is a skin condition linked with facial redness.

A cut or bruise can cause swelling, pain, and discoloration beneath one eye ⁶. Blunt trauma may cause bruising and swelling around the eyelid ³.

Some blunt injuries damage the eye beneath the swollen tissue ³. Blood can collect inside the front of the eye after blunt trauma ³.

High-speed debris can cause a penetrating injury ³. Knives, nails, sticks, and similar objects can also pierce the eye ³. Serious penetrating injuries may require surgical repair ³.

An insect bite near the eye can cause local swelling ⁶. Bites, scratches, and injuries can also let germs enter nearby skin ⁴.

A blocked tear duct prevents normal tear drainage ⁶. The affected eye may remain watery and swollen ⁶.

Eye infections, injuries, and tumors can block a tear duct ⁶. A blockage caused by infection may require antibiotic treatment ⁶.

Conjunctivitis is also called pink eye. Bacterial or viral infections can cause this condition ⁶.

Eye swelling from allergies may be accompanied by itching, burning, or tearing ⁶. Bacterial conjunctivitis may produce white or yellow pus ⁶.

Another infection can resemble conjunctivitis and mainly affect one eye ². It may cause fever, pain, tearing, and swollen lymph nodes near the ear ².

Periorbital cellulitis is an infection of the eyelid or surrounding skin ⁴. It can follow a scratch, injury, or insect bite near the eye ⁴.

The infection may also spread from an infected sinus ⁴. It causes redness and swelling around the eye ⁴.

Periorbital cellulitis generally does not affect vision or cause eye pain ⁴. Antibiotics are needed to treat the infection ⁴.

Painful movement, bulging, or vision changes do not fit this usual pattern ⁴. Those signs can occur when infection involves the eye socket ^4,5.

Orbital cellulitis infects the fat and muscles inside the eye socket ⁵. It can affect the eyelids, eyebrow, and cheek ⁵.

The infection can begin suddenly or worsen over time ⁵. It can also spread from a sinus infection ^5,7.

Possible symptoms include painful swelling of both eyelids ⁵. Fever, bulging, double vision, and reduced vision may also occur ⁵. Eye movement may become painful or difficult ⁵.

Orbital cellulitis can worsen quickly and damage vision ⁵. It may injure the optic nerve, which carries visual signals to the brain ⁵.

Other possible complications include blood infection and meningitis ⁵. Meningitis involves infection spreading to tissues around the brain ⁷.

Cavernous sinus thrombosis can also occur ⁵. This condition involves a blood clot near the base of the brain ⁵.

Eye shingles affects nerves near one eye ¹⁰. It can cause a painful rash across the face or forehead ¹⁰.

The rash may include clustered bumps near the eye or nose ¹⁰. Other symptoms include eyelid swelling, severe pain, redness, and light sensitivity ¹⁰.

Eye shingles can damage vision when treatment is delayed ¹⁰. A clinician should assess suspected eye shingles right away ¹⁰.

Dacryoadenitis means inflammation of a tear gland near the upper outer eye ⁹. An infection or autoimmune disease can cause this condition ⁹.

Symptoms include swelling, pain, warmth, tearing, or discharge ⁹. Nearby lymph nodes may also swell ⁹. Severe swelling may press on the eye and affect sight ⁹.

A cold compress can temporarily reduce ordinary under-eye puffiness. Cooling reduces blood flow and swelling in the area.

Place the cool item over the closed eye for a few minutes. Do not let a home remedy delay care for serious symptoms.

Moist heat is a standard first treatment for meibomian gland inflammation ¹. It helps address thick oil and blocked eyelid glands ¹.

Careful cleaning along the eyelid edges is also standard care ¹. These steps reduce symptoms for many people with meibomian gland inflammation ¹.

Helpful care for inflamed eyelid glands may include:

Avoid rubbing an irritated or swollen eye ^3,6. Rubbing can contribute to puffiness when eyes itch or feel like they contain a foreign object ⁶.

Blinking and tearing may clear a tiny object from the eye’s surface ³. Gentle rinsing with clean water may help remove surface debris ³.

Wash the hands before touching the eye or eyelid ³. Frequent handwashing can reduce the spread of some eye infections ².

Never press an injured eye ³. Do not remove an object that remains embedded in the eye ³.

Leave an embedded object in place while emergency help is arranged ³. Pressure from swelling around the eye can sometimes cause serious eye damage ³.

A compress cannot treat a deep infection or major eye injury. Painful movement, bulging, and vision loss require emergency assessment when swelling is present ⁵.

An over-the-counter allergy medicine may reduce swelling from an allergic reaction ⁶. Follow the product’s label instructions carefully ⁶.

Some meibomian gland problems need prescribed antibiotic ointment ¹. Persistent styes may need antibiotics or drainage by a clinician ⁶.

Steroid medicines are used for selected inflammatory conditions near the eye ^9,10. Eye shingles may require antiviral medicine and other prescribed treatments ¹⁰.

A clinician examines the affected eye, eyelid, face, and surrounding skin ^7,9,10. The clinician will ask when symptoms began and how they changed ^7,10.

Recent injuries, illnesses, and surgery around the eye can guide the assessment ⁷. A recent sinus infection may also be important ^5,7.

The examination may assess the following areas:

A slit lamp exam is one test a provider may perform ¹⁰. Other tests may measure vision and pressure within the eye ¹⁰.

Meibomian gland inflammation can often be diagnosed during an eye examination ¹. Special tests are not generally required for that condition ¹.

Blood tests can look for signs of infection or inflammation ^4,9. A blood culture can check for germs within the blood ^4,5.

Clinicians may culture drainage from the eye or nose ^5,7. These results can help identify the infection involved ⁷.

A CT scan or MRI can show tissues inside the eye socket ^4,5,7. Imaging can help find the cause and possible complications of orbital cellulitis ⁷.

These scans can also show inflammation within a tear gland ⁹. Blood tests or a biopsy may be needed for some tear-gland disorders ⁹.

Treatment depends on the cause found during the examination. Available medical treatments include:

For children, orbital cellulitis requires treatment in a hospital ⁵⁷. Clinicians give antibiotics through a vein and monitor the patient closely ⁵.

Surgery may be necessary when an abscess develops ⁵. An abscess is a pocket of infected material. Surgery may also relieve pressure around the eye ⁵.

Orbital cellulitis is a medical emergency that needs immediate treatment ⁵. Seek emergency care now in these situations:

Trouble breathing with facial or mouth swelling can signal anaphylaxis ⁶. Anaphylaxis is a life-threatening allergic reaction ⁶. If these symptoms occur, call emergency services now.

Chemical eye exposure requires immediate flushing and medical care ³. Follow these emergency steps:

A painful red eye that is unrelated to injury needs urgent medical attention ³. A red, irritated, painful eye also needs clinical assessment ².

Contact a clinician promptly in these situations:

Swelling under one eye can result from irritation, allergy, blocked glands, injury, or infection [1,3-6]. Other symptoms can help identify the likely cause.

A cold compress may ease ordinary puffiness. A device that warms the eyelid and helps clear the glands is a treatment option for meibomian gland inflammation ¹.

Seek emergency care now for bulging, vision changes, or painful eye movement with swelling ⁵. Chemical exposure, embedded objects, and penetrating eye injuries also require immediate care ³.