We’ve all been there: You go to sleep after eating a salty meal, or during an allergy flare-up, or after a good cry — and then wake up the next morning with puffy eyes. 

Also known as periorbital edema, this swelling around the eyes is usually fleeting and nothing to think twice about. “It’s the result of fluid building up in the tissues around your eyes,” explains Carla Ericksen, O.D., an optometrist and the owner of Beyond Vision LNK, located inside an America’s Best Contacts & Eyeglasses in Lincoln, Nebraska. 

All kinds of things can cause your body to hold onto fluid, such as not drinking enough water or having a cocktail with dinner. “When you sleep, you’re not blinking, so fluids can’t circulate properly,” says Dr. Ericksen. That’s why puffiness is usually at its worst when you first get out of bed. Chances are your eyes will return to their normal appearance in about a day. 

But sometimes, puffy eyes are a sign of a more serious underlying problem, such as an injury or a thyroid issue. Read on to learn when you should pay a visit to your eye doctor. 

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The Puffiness Lasts Longer Than 48 Hours 

It can take a day or so for the swelling around your eyes to fully resolve. But if they’re still puffy a full day or two later, there’s a chance there’s something else going on, says Dr. Ericksen. It’s a good idea to get an eye exam in case you need treatment, such as antibiotic eye drops. 

Periorbital edema can also be a side effect of certain medications and treatments, including chemotherapy. Talk with your optometrist about puffy eyes that don’t seem to go away. They can review the medications you take and help figure out if one may be contributing to your puffy eyes. 

Your Eyes Are Unevenly Affected 

People with eye allergies might notice both eyes become puffy after spending time outside during pollen season. This is common, albeit itchy and irritating. But if only one eye is puffy — or if one eye is significantly puffier than the other — it could signal an eye condition or infection, such as: 

• Clogged oil gland (chalazion) 
• Clogged tear duct 
• Pink eye (conjunctivitis), which may spread to the other eye 
• Stye 

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The Puffiness Isn’t Your Only Symptom 

Puffiness on its own is usually nothing to worry about. But if it’s accompanied by other symptoms, such as pain, it could signal an underlying problem, says Dr. Ericksen. She says it’s a good idea to call your eye doctor if you notice these symptoms in addition to puffiness: 

• Discharge 
• Changes in vision 
• Redness 

Recommended reading: 6 Things Your Eyes Reveal About Your Overall Health 

You May Have Injured Your Eye 

If the puffiness comes after you scratched your eye, or you suspect there may be a foreign object in your eye, schedule a visit with your optometrist. They can examine you and come up with a treatment plan for your eye injury. 

Your Eye Has Swollen Shut 

It’s one thing to have puffy eyes. It’s another to not be able to see out of them at all. If one or both of your eyes has totally swollen shut, visit your eye doctor to rule out underlying causes. 

I Have One of These Symptoms. What Do I Do Next? 

First order of business: Call your optometrist and schedule an eye exam immediately. Your eye doctor will check your eyes to determine whether the swelling is due to something innocuous, such as an insect bite, or something more serious, such as an eye injury or infection. 

Undiagnosed eye allergies are the most common culprit of persistent puffy eyes, says Dr. Ericksen. “A lot of times, it’s because the person is allergic to an ingredient in a product they used — like someone with a latex allergy using eyelash glue that has latex in it,” she says. 

Chronic puffy eyes can also be caused by various health conditions, including: 

• Orbital cellulitis. This is an eye infection that is most common in children. It often starts out as a sinus infection. 
• Autoimmune disorders. Graves’ disease specifically can result in an overactive thyroid. 
• Hypothyroidism. This means you have an underactive thyroid. 
• Kidney disease. Decreased kidney function can cause your body to retain sodium and can lead to high levels of protein in your urine, both of which can contribute to puffy eyes. 
• Dermatomyositis. This is a rare inflammatory disease, possibly caused by a virus, that can cause muscle weakness and a skin rash. 
• Infectious mononucleosis. Also known as mono, this infection is caused by the Epstein-Barr virus. Puffy eyes are known to be an early symptom. 

Most of the time though, your puffy eyes are just a sign that you need more sleep or water. But when it comes to your vision and eye health, it’s better to be safe than sorry.

Has it been a while since your last eye exam? Now’s the time to book an appointment!

Medically reviewed by Carla Ericksen, O.D. 

See our sources: 
Puffy eyes overview: Mayo Clinic 
Orbital cellulitis overview: JAMA 
Graves’ eye disease and thyroid eye problems: National Eye Institute 
Signs of kidney disease: National Kidney Foundation