Why is my under eye itchy and swollen

The conjunctiva is a clear layer of tissue lining the eyelids and covering the white of the eye. Allergic conjunctivitis occurs when the conjunctiva becomes swollen or inflamed due to a reaction to pollen, dust mites, pet dander, mold, or other allergy-causing substances.

When your eyes are exposed to allergy-causing substances, a substance called histamine is released by your body. The blood vessels in the conjunctiva become swollen. The eyes can become red, itchy, and teary very quickly.

The pollens that cause symptoms vary from person to person and from area to area. Tiny, hard-to-see pollens that may cause allergic symptoms include grasses, ragweed and trees. These same pollens may also cause hay fever.

Your symptoms may be worse when there is more pollen in the air. Higher levels of pollen are more likely on hot, dry, windy days. On cool, damp, rainy days most pollen is washed to the ground.

Mold, animal dander, or dust mites may cause this problem also.

Allergies tend to run in families. It is hard to know exactly how many people have allergies. Many conditions are often lumped under the term "allergy" even when they might not truly be an allergy.

Symptoms may be seasonal and can include:

• Intense itching or burning eyes
• Puffy eyelids, most often in the morning
• Red eyes
• Stringy eye discharge
• Tearing (watery eyes)
• Widened blood vessels in the clear tissue covering the white of the eye

Your health care provider may look for the following:

• Certain white blood cells, called eosinophils
• Small, raised bumps on the inside of the eyelids (papillary conjunctivitis)
• Positive skin test for suspected allergens on allergy tests

Allergy testing may reveal the pollen or other substances that trigger your symptoms.

• Skin testing is the most common method of allergy testing.
• Skin testing is more likely to be done if symptoms do not respond to treatment.

The best treatment is to avoid what causes your allergy symptoms as much as possible. Common triggers to avoid include dust, mold and pollen.

Some things you can do to ease symptoms are:

• Use lubricating eye drops.
• Apply cool compresses to the eyes.
• Do not smoke and avoid secondhand smoke.
• Take over-the-counter oral antihistamines or antihistamine or decongestant eye drops. These medicines can offer more relief, but they can sometimes make your eyes dry. (Do not use the eye drops if you have contact lenses in place. Also, do not use the eye drops for more than 5 days, as rebound congestion can occur).

If home-care does not help, you may need to see a provider for treatments such as eye drops that contain antihistamines or eye drops that reduce swelling.

Mild eye steroid drops can be prescribed for more severe reactions. You may also use eye drops that prevent a type of white blood cell called mast cells from causing swelling. These drops are given along with antihistamines. These medicines work best if you take them before you come in contact with the allergen.

Symptoms often go away with treatment. However, they can persist if you continue to be exposed to the allergen.

Long-term swelling of the outer lining of the eyes may occur in those with chronic allergies or asthma. It is called vernal conjunctivitis. It is most common in young males, and most often occurs during the spring and summer.

There are no serious complications.

Call your provider if:

• You have symptoms of allergic conjunctivitis that do not respond to self-care steps and over-the-counter treatment.
• Your vision is affected.
• You develop eye pain that is severe or becoming worse.
• Your eyelids or the skin around your eyes becomes swollen or red.
• You have a headache in addition to your other symptoms.

Conjunctivitis - allergic seasonal/perennial; Atopic keratoconjunctivitis; Pink eye - allergic

Cioffi GA, Liebmann JM. Diseases of the visual system. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 395.

Rubenstein JB, Spektor T. Allergic conjunctivitis. In: Yanoff M, Duker JS, eds. Ophthalmology. 5th ed. Philadelphia, PA: Elsevier; 2019:chap 4.7.

Updated by: Linda J. Vorvick, MD, Clinical Associate Professor, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

Swollen eyes or eyelids can be painful and unsightly, but the good news is the swelling usually goes down after a few days. If you are wondering what’s causing your eyes to look puffy, here is a list of common eye conditions:

1. Eye Allergies

Swollen eyelids are often caused by an allergic reaction to something in your environment. If this is the cause, it is usually simple to treat. If you suffer from hay fever, for example, then you’re probably already familiar with the itchy, red, sore eyes you experience when the pollen count is high. Usually, an over-the-counter allergy eye drop will do the trick, but in more severe cases, a prescription drop is necessary.

2. Conjunctivitis

This eye condition can be caused by a bacterial or viral infection, an allergic reaction to pollen or dust mites or an irritant. Some common features include redness of the whites of the eye, a discharge and sometimes crusts on the lashes after sleeping. Conjunctivitis often starts off in one eye and spreads to the other eye after a few hours.

3. Chalazion

A chalazion is a small, harmless bump that appears on the eyelid. It looks a bit like a stye, and is caused by a blocked oil gland. The swelling can be within or on the eyelid, which can often leave it feeling heavy. Chalazia will usually disappear on their own after a few months.

4. Stye

This common eye condition is usually caused by a bacterial infection. The outer part of the eyelid becomes red and swollen and sometimes tiny, raised bumps that are filled with pus appear on the affected area. Styes usually affect one eye, but it’s possible to have them on both eyes at the same time.

5. Eye Injury

When the eye is impacted by a blunt force, it compresses and retracts. This causes blood to collect underneath the damaged area. A common side effect is swelling and discoloration, usually in the form of black eyes.

6. Eyelid Edema

Is caused by excess fluid in the eyelid. In most cases eyelid edema is caused by a reaction to an allergen or something that has been applied to the eye area, like makeup wipes or eye drops.

7. Orbital cellulitis

This condition occurs when the inflammation in your sinuses spreads to the eye area. There is typically redness and swelling of your eyelid and around your eye. Orbital cellulitis is far more common in children than in adults.

8. Blepharitis

This condition usually affects both eyes and is caused when the edges of the eyelids become inflamed. Some common features include sore, itchy eyes that feel like they’re burning. Yellow crusts on the eyelashes are also common.

9. Graves’ Disease

Is an auto-immune condition that causes your eyes to become inflamed. It is due to an overactive thyroid gland producing too much thyroid hormone, which can cause one or both eyes to bulge. Graves’ disease is also known as Thyroid Eye Disease (TED). Those with this condition often develop other eye symptoms like dryness and irritation of the eyes. Also, the eye muscles can become inflamed, affecting eye movement.

10. Eye cancer

This is rarely the cause for swollen eyes, but in some instances, it can be a cause for concern when it is accompanied with other symptoms. If you have been experiencing blurred vision, loss of vision or see floaters — squiggles or spots — moving slowly in your vision field, then it may be a sign of something more serious.

If you have had swelling around your eyes for longer than a few days, be sure to contact our office to schedule an eye exam. If treated early enough, most of these eye conditions can be easily treated.

How do you treat swelling under the eye?

What causes swelling under one eye?