Edema of the eyes is determined with ophthalmic, some otolaryngological and somatic diseases, traumatic injuries, violations of the daily routine, contact with allergens. It is localized on the upper, lower or both eyelids, it can be one- or two-sided. More often seen better in the morning. May be accompanied by increased lacrimation, pain in the eyes, pain, redness of the skin, conjunctiva. The cause is established on the basis of the data of the survey, physical examination, examination of the structures of the eye, radiography, ultrasound. Prior to diagnosis, visual rest is indicated.
The most common physiological cause of puffiness under the eyes in the morning is the intake of large amounts of liquid, alcohol, spicy, salty foods in the evening. Edema is bilateral, symmetrical. In the case of sleeping in one position, it may be stronger on the side on which the person slept. Disappears after 1-2 hours. Other triggering factors include:
Age plays a significant role in the appearance of edema. However, swelling under the eyes in older people is not necessarily due to edema, a similar impression is created by fatty bags protruding under the skin. Unlike edema, such swelling is stable and does not decrease during the day.
In women, swelling of the eyes sometimes appears due to improper use of cosmetics (for example, applying a greasy cream at night), the use of products with skin-irritating components, and individual intolerance. Another possible cosmetic reason is tattooing.
Normally, swelling after tattooing disappears within a day. Long-term persistence of the symptom may indicate poor quality or too deep injection of the pigment, the wrong choice of anesthetic, increased dryness of the skin of the eyelids, the development of an allergic reaction. In addition, short-term reactive edema is found after anti-aging procedures: eyelid lifting, contouring.
Swelling of the upper eyelid
Many women notice swelling of the eyes before the onset of menstruation. This symptom is especially pronounced in patients with premenstrual syndrome. Hormonal changes during gestation contribute to the accumulation of fluid in the tissues, so pregnant women often notice swelling under the eyes, which increases as the duration of pregnancy increases. Along with physiological hormonal changes, edema may be due to impaired renal function.
Menopause is also associated with changes in hormone levels. During this period, patients are often worried about the pastiness of the eyelids and faces, which are most noticeable in the morning hours, which do not disappear even with enough sleep, strict adherence to the drinking regimen. Sometimes puffiness in the elderly develops against the background of hormone replacement therapy, and in women of reproductive age - as a result of taking oral contraceptives.
Edema accompanies many inflammatory and non-inflammatory eye lesions. The following pathologies become the cause of swelling:
Styes are the most common reason for visiting ophthalmologists, accompanied by limited local edema. The swelling grows rapidly, is combined with pain, hyperemia, sometimes reaches such an extent that the patient cannot open his eyes. Then a yellowish purulent focus appears in the center of the swelling. After spontaneous or active opening of the abscess, edema and other manifestations quickly regress.
With an uninfected chalazion, there is no edema. The development of the inflammatory process is marked by the appearance of local edema, redness, pain. With the formation of an abscess or phlegmon of the eyelid, the puffiness becomes pronounced, spreading to the entire eye. Pulsating pain is noted, blepharitis, hyperthermia, and symptoms of intoxication are sometimes detected.
Dacryocystitis occurs against the background of dacryostenosis (impaired patency of the lacrimal canal). The swelling is localized in the inner corner of the eye. When pressing on the affected area, a purulent or mucopurulent secret is released from the lacrimal openings. Pathology can be complicated by phlegmon of the lacrimal sac. In such cases, the eyelid is completely closed due to swelling, swelling covers the cheek, paranasal region, sometimes the opposite side of the face.
With endophthalmitis, the edema is moderate, there is a pronounced injection of the mucosa, the formation of a purulent focus, translucent through the pupil. In patients with panophthalmitis, all structures of the eye are involved in the process. The edema is so severe that it sometimes leads to infringement of the mucous membrane for the eyelids. Exophthalmos, clouding of the cornea, melting of the iris, a sharp decrease in vision up to blindness are determined.
Erysipelatous inflammation of the eyelids is manifested by a pronounced edema extending to the upper part of the cheek. The movements of the eyelids are limited due to swelling. The skin in the affected area becomes hot, painful. In the gangrenous form, the formation of ulcerative defects is observed. There is an increase in temperature, symptoms of intoxication, regional lymphadenitis.
Edema is a constant symptom of mechanical damage to the eyes, which include:
Eye burns are often chemical, caused by alkalis, acids, components of self-defense aerosols, building paints, varnishes. Thermal damage develops under the influence of steam, metal particles, flammable mixtures for fireworks. Radiation burns are provoked by ionizing radiation, infrared or ultraviolet rays.
A special form of radiation burns of the eyes is snow blindness - damage to the eyes by ultraviolet radiation at high altitude. Swelling in burns is combined with lacrimation, photophobia, pain, redness of the skin of the eyelids, conjunctiva. In severe cases, foci of necrosis are formed. Under thermal exposure, the structures of the eye may remain intact due to reflex closure of the palpebral fissure.
In addition, severe swelling, periorbital hematomas are observed with fractures of nearby bone structures: the upper jaw, zygomatic bone, and nasal bones. It is especially necessary to highlight fractures of the base of the skull (middle cranial fossa), in which the symptom of glasses is hemorrhage, swelling of the periorbital zone does not appear immediately, but 12-24 hours after the injury.
Lesions with puffy eyes can be associated with infection with bacteria, viruses, intracellular parasites that cause STIs. Infection with chlamydia trachomatis occurs by contact - the pathogen enters the eyes through hands, napkins, handkerchiefs, towels. It causes trachoma, which initially proceeds with symptoms of conjunctivitis (paratrachoma), and then is complicated by corneal lesions.
Blennorrhea in adults in 2/3 of cases is provoked by gonococci, sometimes associations with chlamydia are detected. Swelling, redness, suppuration from the eyes are noted. Perhaps the formation of corneal ulcers, the development of endophthalmitis, panophthalmitis. Ophthalmoherpes is caused by the herpes simplex virus, occurs when an accidental infection or persistence of the pathogen in the body. Edema is combined with manifestations of conjunctivitis, uveitis, iridocyclitis.
The list of parasitic infections with eye swelling includes the following diseases:
Sudden swelling, itching, burning, redness of the conjunctiva are found in allergic conjunctivitis and blepharoconjunctivitis. During the flowering period of plants, pollinous conjunctivitis is often detected. At other times of the year, swelling of the eyelids and other symptoms may be due to allergies to salicylates, house dust, animal dander. Pronounced swelling of the eyes, combined with swelling of the face, difficulty breathing is observed with Quincke's edema.
Orbital pseudotumor is most often diagnosed in patients suffering from autoimmune diseases: SLE, periarteritis nodosa, Wegener's disease. Depending on the location of the lesion (oculomotor muscles, lacrimal glands, blood vessels), edema can be combined with diplopia, exophthalmos, pain, ptosis, hyperemia of the skin and mucous membranes.
Endocrine ophthalmopathy develops in patients with autoimmune thyroid pathologies. Manifested by swelling of the periorbital region, photophobia, lacrimation, a feeling of pressure, "sand" in the eyes. Perhaps the occurrence of unilateral or asymmetric exophthalmos. The course of the pathology is chronic progressive, the increase in edema is supplemented by diplopia, headaches, and conjunctival injection.
With plastic rheumatic uveitis, edema appears at the initial stage, along with signs of conjunctivitis. In the future, changes in the pupil, pain, photophobia, lacrimation join. In other forms of rheumatic uveitis, swelling may be absent.
Along with diseases of the eyes and their appendages, edema can be provoked by the following pathological conditions:
Ophthalmologists are engaged in finding out the cause of swelling of the eyes. According to the indications, patients are referred for a consultation with a maxillofacial surgeon, an otolaryngologist, a therapist, and other specialists. The doctor specifies the time and circumstances of the onset of the symptom, establishes other signs of the disease, and conducts an external examination. To assess the condition of the eyes, the following diagnostic procedures are performed:
Eye swelling treatment
In case of burns, rinse the eye with running water. The use of alkalis and acids to neutralize the action of chemicals is prohibited. Patients with injuries should be bandaged to ensure rest, avoid eye movements and visual strain. It is impossible to remove foreign bodies on your own, so as not to aggravate the damage. With all eye diseases, it is important to observe the rules of personal hygiene.
Tactics of conservative treatment is determined by the cause of swelling under the eyes. It is possible to use the following drugs:
According to indications, parabulbar, retrobulbar, subconjunctival injections are carried out. Apply physiotherapy techniques, massage the eyelids.
Depending on the nature of the pathology, the following surgical interventions can be performed:
In the late period after injuries and purulent diseases, some patients require elimination of ptosis, correction of eversion or inversion of the eyelid, antiglaucoma surgery for secondary glaucoma, and other interventions.