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Puffy eyes, one eye smaller than the other, pressure on one eyelid. May I know the cause?

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Dear Dr,

Recently I noticed that my eye always look puffy all days and my left eye grew smaller than my right eye. As I close my eye, I can feel pressure on my left eyelid . May I know whats the caused?
Posted Mon, 16 Apr 2012 in Vision and Eye Disorders
Answered by Dr. Mihir Shah 8 hours later
Thanks for posting your query.
Periorbital puffiness, also known as "puffy eyes" or swelling around the eyes, refers to the appearance of swelling in the tissues around the eyes, called the orbits. It is almost exclusively caused by fluid buildup around the eyes, or periorbital edema. Minor puffiness usually detectable below the eyes only is often called eye bags.

While some degree of puffiness may be normal for a given individual, factors such as age and fatigue may make the swelling more prominent. The periorbital tissues are most noticeably swollen immediately after waking, perhaps due to the gravitational redistribution of fluid in the horizontal position.
Eye puffiness may also be caused by:

* Oversleeping/sleep deprivation - Interrupted sleep cycles are common causes of eye puffiness.

* Fluid retention - Many conditions (including pregnancy and hormonal variations with menstruation) can lead to the retention of fluid, particularly in the subcutaneous tissues. These conditions can cause swelling around the eyes to be more prominent.

* Diet - Excess salt encourages fluid retention and may lead to puffy eyes.

* Alcohol and tobacco use - Alcohol and tobacco contain toxins that may lead to stress, fatigue, and hormonal changes; all of which may lead to fluid retention and swelling around the eyes.

* Allergies - Allergic reactions can lead to leaks in the subcutaneous capillary beds which can cause swelling in the face, including around the eyes.

* Skin disorders - Eye puffiness can be a side effect of certain skin disorders, such as dermatitis, if the affected area becomes very sensitive, leading to swelling.

* Normal aging - As a person grows older, the skin around the eyes becomes thinner and may swell or droop.

* Crying - The salt in tears may cause fluid retention in the eye area.

* Hypothyroidism - Facial puffiness and periorbital swelling occur due to infiltration with the mucopolysaccharides hyaluronic acid and chondroitin sulfate, pulling fluid into the interstitial space by osmosis.

* Periorbital cellulitis - An inflammation and infection of the eyelid and portions of skin around the eye.

* Kidney disorder - One of the first signs of kidney disorder is periorbital swelling.

Suggested remedies:
For someone predisposed to eye puffiness, changes to diet and lifestyle (under the supervision of a physician) may be required to reduce the possibility of swelling. A cold compress near the eye can act as a short-term remedy as cold temperature constricts blood vessels, preventing the flow of fluid into tissues and diminishing puffiness in the process. A natural astringent, such as wet tea bags, a sliced cucumber, or even potato can also provide short-term relief.
Elevating the head while sleeping can prevent the gravitational redistribution of fluid that is associated with eye swelling. A low-carb diet can prevent eye puffiness by preventing water retention. Eating foods XXXXXXX in vitamins, especially A, C and E, helps to reduce eye puffiness.
I will be available for any further queries.

Best regards,
Dr.Mihir Shah.
Above answer was peer-reviewed by
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