Randomly Having Puffy Eyes All My Life? (photo)

Hello, I am a 30 year old male who has had issues with puffy/swollen eyes all my life. On the pic you can see the difference that 1 day can make. One day I look rested, the other day my eyes look very swollen. I drink plenty of water, get 8h sleep a night, do not drink much alcohol, and eat a healthy diet. I have done a blood test, and my thyroids are OK I am told. I do not have allergies (as far as I know). More sleep == more puffy eyes for me. What can cause these random puffy eyes?

Doctor Answers 1

Why do I have puffy eyelids?

Puffy lids can be very annoying. A common reasons for persistently full puffy lids, especially under the eyes, are pockets of orbital fat that slowly begin to protrude. Thyroid issues can create this as well. But when puffiness/fullness comes and goes, it may involve fluid and/or allergy issues. After a salty meal, for example, we may retain more fluid including the eyelid area. The prone/supine position, of course, creates more facial fullness ((ie getting up in the morning..don't we look puffy and sometimes scary?). And allergies to substances we inhale/ingest/touch can create more edema in the face & eyelid.  Some people who for unclear hereditary reasons seem to retain more eyelid fluid. The lower eyelid/upper cheek skin can sometimes create "festoons" that can be very difficult to treat.  

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