Any swelling or inflammation to the areas surrounding the eye may lead to swollen eyelids in children. In addition, various factors such as infections, allergies, and injuries could cause swelling in the eyes or eyelids of your child. Some conditions lead to swelling in one eye, while others may cause swelling in both eyes. It is important to identify the signs and underlying causes for swollen or puffy eyelids in children to seek early treatments and avoid complications and future risks. This post describes the signs and symptoms, possible causes, treatment, and management options for swollen eyes and eyelids in children.
Symptoms Associated With Swollen Eyes In Children
The following symptoms are often associated with swollen eyes in children (1). Depending on the cause of swelling, associated symptoms may vary. Some conditions can be painful, whereas others may not cause pain despite causing swollen eyes. Depending on the severity, an eye swelling scale is established. This includes (2):
Mild swelling when the eyelid is puffy, but the child can open eyes normally. Moderate swelling when the eye is puffier, and there is some limitation in opening the eyes. Severe swelling when eyelid swelling closes the eyes, and children cannot open them.
Some eye conditions may also cause symptoms such as headache, fever, etc. You may seek medical care to identifying the underlying reasons for these signs and symptoms.
When To See A Doctor
Some conditions are self-limiting, while others may require medical care. You may seek immediate care if your child has (2):
Swelling with redness of the eye Yellow or green pus discharge from the eyes Swelling due to eye injury Cuts or laceration of the eye Bleeding from the eye Swelling of other parts of the body Swelling not improving with current treatments
It is usually good to see a doctor for any severe eye swelling and other symptoms since the eyes are delicate organs. Medical care can help in the exact diagnosis and treatment of the underlying condition.
Common Causes Of Eye Swelling In Children
Children can have eye swelling in one or both eyes. You may look for the other existing symptoms and signs to identify the condition. However, seek medical care if you face difficulty differentiating mild and severe causes to begin early treatment. The following conditions may cause one-sided eye swelling (swelling in one eye) in children (3).
1. Rubbing the eye
Most children tend to rub their eyes if they have eye irritation. This may often cause swelling of the eyelids. Rough rubbing of the eyelids with dirty hands could increase eye irritation and make the eyelids swollen. The important thing here is the initial cause of the eye irritation that led to the rubbing. Often it is allergies. According to Yuna Rapoport, MD, MPH, a board-certified ophthalmologist in New York, “Most swollen eyelids are just allergies or water accumulation, but it can be a sign of a serious infection such as cellulitis, or even a rare tumor like rhabdomyosarcoma.”
2. Insect bite
An insect bite near the eye could cause swelling since the body reacts to it. Mosquito bites are quite common, and the eye may swell more than other body parts after a mosquito bite since the tissues are loose near the eye. Bee or wasp sting near the eye can also cause swelling of the eye. You may notice more puffiness of the eye due to bee or wasp sting than a mosquito bite.
3. Contact dermatitis
Contact dermatitis occurs after the skin comes in contact with irritants or allergens such as poison ivy, certain soaps, baby products, etc. Allergens trigger skin inflammation that causes redness and swelling of the exposed area. If the skin near the eye is exposed to allergens, children may develop eye swelling.
4. Eye injury
Mild ocular trauma (eye injury), such as being struck by a moving object, can cause eye swelling. Children are vulnerable to eye injuries during sports and games. Mild eye injuries may cause a black eye due to bruising around the eye. Severe injuries may cause bleeding, and the bruising can be red-colored. If your child has a black eye, you may apply an ice pack immediately to reduce swelling. However, it is recommended to seek medical care to rule out other damage.
5. Stye
A stye, also known as a hordeolum, is a painful, red lump under the eyelid. A staphylococcal bacterial infection usually causes these small lumps (4). It may appear swollen and often causes itching. Stye may look like a pimple and is usually due to infection in the glands along the eyelid. An external stye is due to the infection of glands of Zeis (oil gland) or Moll’s gland (sweat gland) present at the base of eyelashes. An internal stye is due to infection of the meibomian gland (oil gland), which is located in the eyelid. A stye may also appear if your child has blepharitis, which causes redness and swelling at the base of the eyelashes.
6. Chalazion
Enlargement of the meibomian gland in the eyelid is known as a chalazion. It appears as a swollen bump on the eyelid, and it may often begin as a style. The eyelid can become swollen, red, and tender during chalazion, but it may not cause pain. If the chalazion is too large, it may cause blurred vision due to compressions against the eye. Rarely, the entire eyelid may become swollen during a chalazion. A chalazion is painless swelling, whereas stye is painful and often develops along the rim or edge of the eyelid.
7. Dacryocystitis
Dacryocystitis is an inflammation of the lacrimal sac (tear sac) that usually happens due to the nasolacrimal duct (tear duct) blockage, which drains tears into the nose. It is located in the corner of the eye and appears swollen and red. Lumps are usually painful, and children may have a fever.
8. Ethmoid sinus infection
Ethmoid sinusitis may cause eyelid swelling and redness since it is located right behind the eye. Children may develop painful, puffy eyes during severe ethmoid sinus infections. Pain and tenderness between eyes or on the nasal bridge is a characteristic finding in ethmoid sinus issues.
9. Periorbital cellulitis
Periorbital cellulitis involves the infection of the eyelid or the skin around the eyes. The infection usually spreads from an infected wound or insect bite site. The eyelid may become red and painful in this condition.
10. Ocular herpes
Eye herpes or ocular herpes is a severe infection caused by the herpes simplex virus that usually affects one eye, although it could infect both eyes. Redness, pain, watery discharge, and light sensitivity are symptoms seen along with swelling (5). Seek immediate medical care if your child has eye herpes since it often causes keratitis (corneal inflammation) and scarring that often requires corneal transplant to avoid permanent vision damage. The following conditions can cause eye swelling on both sides (swelling in both eyes) (3).
11. Allergic conjunctivitis
Allergic conjunctivitis is the inflammation of the conjunctiva caused by exposure to allergens. Common allergens include airborne allergens, such as pollen, dust, or certain fumes or chemicals. This may also cause redness and tearing up of the eyes, along with the swelling.
12. Viral conjunctivitis
Viral conjunctivitis is the viral conjunctival infection, usually caused by adenovirus (6). This can cause swelling of the eyes on both sides. Watery discharge, light sensitivity, irritation are other common symptoms present with a viral infection. Children with colds may often develop viral conjunctivitis.
13. Bacterial conjunctivitis
Bacterial conjunctivitis is the bacterial infection of the conjunctiva that may result in swelling of the eyes. Yellow discharge is common in this condition, and this may also cause eyelids to stick to each other. Sinus infections and ear infections often cause bacterial conjunctivitis in children.
14. Edema around the eyes
Systemic conditions that cause fluid retention in the body may lead to puffy eyes. Problems with the kidney, heart, and liver often cause swelling of the eyes. You may also notice swollen feet in such cases.
15. Anaphylaxis
Anaphylaxis or severe allergic reactions may often cause swelling of the eyes along with other symptoms. Breathing problems, swallowing difficulties, and hives (skin rashes) are often seen in allergic reactions. Certain foods, bee or wasp sting, and drugs are significant causes of anaphylaxis in children.
16. Grave’s ophthalmopathy
Grave’s ophthalmopathy or thyroid eye disease (TED) involves the orbit and periorbital tissues (7). This is an autoimmune inflammatory disorder usually affecting people with Grave’s disease, and less frequently, people with Hashimoto’s thyroiditis. Swelling of the eyes, eyelid retraction and lag, redness, and exophthalmos (bulging eyes) are usually seen in this condition.
17. Blepharitis
Blepharitis is a chronic condition causing inflammation of the eyelids. This is often due to conditions such as a stye, chalazion, etc. that clog oil-producing glands of the eyes. Although it is not a contagious disease, this may lead to permanent eye damage. There are various eye diseases and conditions that may cause swelling, redness, and pain in the eyes. It is essential to begin home care and other medical treatment before the swelling enlarges or causes eye damage.
Home care For Eye Swelling In Children
If the eye swelling is mild, the following home care tips may help relieve it (8).
Apply cool compresses such as a splash of cold water or eyes pack over the swollen eye. Black eyes (due to trauma) can be cured by applying an ice pack for 15 to 20 minutes every hour. You may wrap the ice in a cloth to prevent freezing the skin. In viral conjunctivitis, wash hands often, and change pillow covers to prevent reinfection or contamination. Avoid sharing towels and other personal items among family members during infection. Use sunglasses to protect the eye from dust, pollens, etc. during outdoor activities. Do not squeeze the stye, chalazion, etc. since the infection may spread to more areas. Do not rub the eyes since it may increase swelling. Avoid contact lenses during eye problems.
Do not hesitate to seek an ophthalmologist’s help if symptoms are not resolving or are severe. If your child has blood in the eye, blurred vision, or cannot open or move their eyes, you may seek immediate medical care instead of home treatments.
Treatment For Swollen Eyes In Children
The treatment may vary depending on the severity and underlying cause. Some causes are self-limiting, whereas a few conditions may require ophthalmic (eye) surgeries to relieve the swelling. The doctor may advise not to rub eyes and observe home care if the condition is not severe. Puffy eyes due to kidney problems, thyroid abnormalities, etc. may require managing these conditions. The treatment of underlying causes would usually resolve eye swelling without any specific treatment for swollen eyes. The following treatments are given for eye swelling in children (2).
Oral allergy medicines and antihistamine eye drops are given for allergy-related causes. Artificial tears are prescribed to relieve other symptoms such as dryness and itching in the eye. Antiviral or antibacterial ointments or creams are given for infectious causes. Photochromic or specialized lenses could be recommended if your child has sensitivity to light along with eye swelling. Trauma and bleeding may often require surgical repair to cure eye swelling and prevent complications.
