Start with the warning signs
Before working through the everyday causes, check for the signs that need a doctor today. The FDA lists swelling, along with redness, pain, discharge, blurred vision and light sensitivity, among the symptoms of eye irritation or infection that mean you should remove your lenses and contact your eye care professional.[5]
An infection of the eyelid or the skin around the eye, called periorbital cellulitis, causes redness and swelling of the eyelid and the surrounding area, and is treated with antibiotics.[1] MedlinePlus advises contacting your provider right away if the eye becomes red or swollen, if a fever develops with eye symptoms, if it’s difficult or painful to move the eye, if the eye looks like it’s bulging, or if your vision changes.[1] Those signs need care the same day.
Common causes in scleral wearers
Handling in the early weeks. New wearers sometimes describe puffy lids the day after wearing new lenses. Holding the lids open, repeated attempts, and touching the eye more than usual can all play a part. If it’s mild and settling, mention it at your next visit; your fitter can watch your technique. See how to insert and how to remove.
A stye or chalazion. A stye is a red, swollen, tender bump at the lid edge, and the infection can sometimes spread to the rest of the eyelid.[2] See stye or chalazion.
Pink eye. The National Eye Institute lists swollen eyelids among the symptoms of pink eye.[3] See scleral lenses and pink eye.
Allergy. Seasonal allergies, pets, or outdoor allergens can make lids puffy and itchy. Some wearers find a gentle lid cleanser after removal helps clear allergens. If you take allergy tablets, ask about dryness: the National Eye Institute lists dry eye as a possible side effect of some allergy medicines.[4] See scleral lenses and allergies.
A reaction to a product. Wearers have traced lid swelling to a lubricating drop placed in the lens bowl, a saline that turned out not to be preservative-free, a new cleaner, eye makeup, or even gel or acrylic nail products touching the eye area. If swelling started after you changed something, tell your fitter what changed. See makeup and skin care.
Blepharitis. Inflamed lid margins can make the lids look swollen along the lash line. See blepharitis and MGD.
Fit. A lens edge that presses into the white of the eye can cause local redness and swelling of the conjunctiva. A few wearers have needed a pause from lenses and treatment from their eye doctor after a too-tight lens. See is my lens too tight?
Sleep, fluid and long screen days. Some wearers notice puffier lids after poor sleep or long days. That’s worth mentioning, but it isn’t a reason to skip a check if the swelling is new.
Swelling of the eye itself
Sometimes the swelling is in the clear membrane over the white of the eye rather than the lid: it can look wrinkled, jelly-like or raised. Wearers who had sudden episodes like this were usually told it was likely allergic, but to get an eye doctor’s look. If it happens with a lens in, remove the lens and call.
What to note before you call
- Which eye, and when it started
- Whether it’s red, warm, itchy or painful
- Any discharge, blur or light sensitivity
- Anything new: a drop, saline, cleaner, makeup, nail product, or a new lens
- Whether it’s better or worse with the lens out
A photo in good light helps your eye doctor or fitter.
What wearers say
- Early puffiness often settles. Some new wearers had puffy lids for a while as they learned to handle their lenses, and it eased as handling became quicker and gentler.
- Products are a frequent culprit. Several wearers found the swelling stopped once they changed a drop, a fill, a cleaner or a beauty product.
- Red and spreading needed a doctor. Wearers with a swollen, red eyelid who saw a doctor were sometimes treated for an eyelid infection with antibiotics, rather than the blepharitis they expected.
What to ask your fitter
- Could my handling or lid technique be causing this?
- Could any of my drops, fill or cleaning products be causing a reaction?
- Is the lens pressing anywhere it shouldn’t?
- Should I stop wearing the lenses until the swelling is gone?
Common questions
My lids were puffy in my first weeks with lenses. Is that normal?
Some new wearers describe puffy lids in the early weeks, often linked to the extra touching and stretching of the lids during insertion and removal. Mention it to your fitter, who can check your technique and the fit. Swelling that keeps getting worse, or that is red or painful, isn't something to wait out.
Could my lens be too big or too tight?
A lens that presses on the conjunctiva can cause redness and swelling of the white of the eye around the edge, and some wearers have needed a refit for it. Your fitter can check this, ideally while you're wearing the lens late in the day.
Should I use warm compresses?
For a stye, warm compresses are a standard first step. For other kinds of swelling, especially if it's red, hot or spreading, call your eye doctor before treating it yourself.
Can I take an antihistamine for puffy eyes?
Ask your doctor or pharmacist. Some allergy medicines can dry the eyes, which matters with scleral lenses, and swelling from an infection won't respond to an antihistamine.