Dealing with Eyelid Puffiness

It’s a simple fact of life: As you age, things stretch out. I hate it, and I know you do, too. You could hide those puffy eyelids behind your glasses, but now everyone seems to be getting rid of glasses when getting cataract and lens implant surgery. So now everyone can see the puffy eyelids, including you!  

Gravity plays a role in this, as well. Sir Isaac Newton may have been hit on the head by a falling apple,  but he also had puffy eyelids when you look at the paintings of his face. He could have discovered gravity by just looking in the mirror. Not only does the skin get stretched out, but fluid pools behind the skin, and gravity makes it sag.  

If you’re a movie star or social media influencer, maybe you can get eyelid surgery to tighten up the puffy, sagging skin, but otherwise, here are some things you can try to tighten things up.  

Tips to Minimize Puffiness

Most people notice the puffiness is worse first thing in the morning. Lying flat while you sleep allows the fluid in your body to pool in the loose skin around your eye socket. Later in the morning, it may seem better, but one way to minimize the morning puffiness is to raise the head of your bed. If you don’t have an adjustable bed to do this, just put a book under the bedposts at the head of your bed. Or you can fold a blanket and put it under your mattress at the head of the bed to raise it slightly and keep fluid from pooling around your eyes in the morning.  

Cold Compresses

You see all these pictures of people at spas with cucumbers on their closed eyelids. It’s not so much the cucumbers helping, but more likely the cold that constricts the blood vessels and helps shrink the puffiness. So, any cold compress can do this, and you can leave that on as long as it takes to tighten up the skin and reduce the swelling.  

Even better for some is a trick that’s hard to believe. My father was an eye surgeon, and my mother worked in his office for many years. She told me about this, so I guess that makes it an “old wives’ tale.”  Caffeine is known to constrict blood vessels. So, if you take the tea bag you use to make a cup of tea and put it in the refrigerator instead of throwing it away, you can take that out in the morning and place it on your eyelids. You get both the benefit of the cold compress and the caffeine in the tea will soak into the skin and shrink the blood vessels to minimize the redness and puffiness around your eyes.  

When to Seek Medical Attention

There are other reasons beyond age that can make your eyelids puffy. So, you can discuss this with your medical doctor to consider things like thyroid disease, skin disease, sinus disease, allergies, and fluid retention problems. Sometimes the puffiness can become so severe that the lower eyelid sags away from your eyeball and causes a medical condition called ectropion. Plastic surgery of your eyelid may be needed to correct this to avoid problems with your eye or your vision, and medical insurance will usually cover this surgery as it’s a medical condition. 

It’s always a good idea to get a quick check for this with your eye doctor. And we at SureVision Eye Centers will be happy to help care for your puffy eyelids.  

Lawrence A. Gans, MD, FACS
Medical Director