What to do when your eyes swell due to allergies?

When allergies strike, many people focus on nasal or respiratory symptoms and neglect the eyes.

Eye allergies, or allergic conjunctivitis, can occur in spring, summer or fall, usually due to grass, tree or ragweed pollen. Indoor allergens such as dust mites and pet dander are also potential triggers.

Eye puffiness or swelling is a common symptom of allergic conjunctivitis, along with itchy, red eyes, a burning sensation and a clear, watery discharge.

Many allergy patients express concern about eye puffiness. How does it occur?

During an allergic reaction, white blood cells attach to protective mast cells in the mucus membranes of the eyes and nasal passages, and fluid builds up. Tiny blood vessels in and around the eyes leak, leading to inflammation and swelling in surrounding tissues and the watery discharge.

Rubbing or scratching the eyes only makes it worse – and could lead to infection.

What causes the dark, blue-tinted circles under the eyes?

This is the so-called “allergic shiner” – when there’s swelling of tissue and fluid buildup in and around the eyes, blood starts to pool, darkening the skin and creating dark circles.

The “allergic shiner” is also a common sign of environmental allergies to pollen, dust mites or pet dander, and it can also indicate food allergy.

Why do eyes mostly swell at night?

One reason may be exposure to allergens in the bedroom – primarily dust mites and pet dander. Dust mites are one of the most common causes of eye and nasal allergies. Consider using dust mite-proof mattresses and pillow encasings and wash your bed linens weekly.

It’s also important to keep furry pets out of the bedroom to reduce the presence of animal dander when you sleep at night. Washing your hair after time spent outdoors removes pollen and keeps it from collecting on your pillow while you sleep.

What are some remedies?

First, talk with your doctor about developing an allergy treatment plan that addresses nasal, respiratory and eye symptoms.

Preservative-free eyewash or artificial tears can wash out allergens and moisten dry, irritated eyes. These are usually available without a prescription.

Over-the-counter and prescription eyedrops and oral medications can also be used to treat eye allergies.


Oral antihistamines can help relieve itchy eyes, but they may also dry out the eyes. Decongestant eyedrops (with or without antihistamines) can help reduce eye redness associated with allergies, but they should not be used for more than three days or they may worsen irritation.


Antihistamine eyedrops can reduce eye swelling, itching and redness associated with allergies. Antihistamine drops combined with a mast cell stabilizer provide relief for itching, redness and burning sensation and can also prevent symptoms. For severe eye allergies, you may be prescribed mild corticosteroid drops – these should only be used for conjunctivitis caused by allergy, not bacterial infections. Eye allergies cause clear, watery discharges while bacterial infections cause yellow or greenish secretions.

When eye puffiness is bothersome, place a cool, damp washcloth over the eyes to help reduce swelling. If you wear contact lenses, it’s best to remove them until the puffiness subsides; be sure to clean them regularly to remove allergens.

Reviewed by Bradley Chipps, MD