DIAGNOSIS CHECKLIST
for Puffy eyes

Why: to determine if acute or chronic.

Why: e.g. eyelids or the eyes themselves. If the eye itself is puffy may suggest glaucoma, orbital cellulitis or ulcers on the surface of the eye.

Why: e.g. localized puffiness near the inner corner of the eye may suggest dacrocystitis; styes cause a painful, red localized swelling of the lid margin, usually on the side of the lid closest to the nose; allergies, nephrotic syndrome, cellulitis, sinusitis usually cause generalized puffiness of the eyelid.

Why: Normal aging may cause mild puffy eyes and sagging skin around the eyes.

Why: may indicate viral conjunctivitis.

Why: may indicate bacterial conjunctivitis.

Why: may indicate possible allergic reaction with puffy eyelids.

Why: may suggest allergic conjunctivitis.

Why: e.g. Nephrotic syndrome may cause generalized puffiness of the eyelids and may be caused by systemic lupus erythematosus and diabetes; blepharitis may be associated with seborrheic dermatitis, eczema or Rosacea; ocular herpes is caused by a reactivation of varicella zoster virus (acquired from primary infection of chickenpox) sometimes by an underlying malignancy (e.g. leukemia or lymphoma) or immunosuppression ( e.g. AIDS infection).

Why: e.g. many medications such as penicillamine, high dose captopril and gold may cause nephrotic syndrome which can cause generalized eyelid puffiness.

Why: e.g. dust mite, mold, pollens, chemicals - may indicate allergic conjunctivitis or hay fever; allergies may be associated with minimal change disease which is a cause of nephrotic syndrome.

Why: e.g. West African trypanosomiasis found mainly in West Africa, Southern Sudan and Uganda and may cause puffy face and puffy droopy eyelids; Lassa fever is confined to sub-Saharan West Africa and may cause puffy eyelids; Trichinosis is found predominantly in the USA and Europe; Chagus' disease is confined to South and Central America.

Why: may indicate herpes zoster if rash is blister-like.

Why: may indicate sinusitis, herpes zoster infection, orbital cellulitis.

Why: may suggest allergies or blepharitis.

Why: may indicate sinusitis, orbital cellulitis, trichinosis, Chagas' disease.

Why: e.g. purulent (pus-like) discharge usually indicates a bacterial infection; a clear watery or mucous discharge may suggest viral or allergic conjunctivitis.

Why: e.g. nasal blockage, facial pain and tenderness, puffy eyelids.

Why: e.g. facial swelling, especially around the eyes; swelling of the arms, genitals and sometimes abdomen; frothy urine.

Why: e.g. abrupt onset of swelling and redness of the eyelids, proptosis (forward bulging of the eye).

Why: e.g. painful , tender, red, swelling of the lid, which after a few days localizes and cures itself spontaneously by discharging pus at the lash base.

Why: e.g. eyelids have burning, itching with red and sometimes puffy margins, eyelashes may have crusting and scales, discharge or stickiness especially in the morning. If present for years there may be loss of eyelashes or distortion (in-growing) of the eyelashes. There may be a Staphylococcal bacterial infection which can cause severe inflammation with pus-like discharge.

Why: e.g. swelling and redness of the tear sac near the inner corner of the eye.

Why: e.g. pain, tingling and numbness around the eye may precede a blistering rash and eyelid puffiness. Fifty percent of people have the eye itself affected with either corneal ulcers, episcleritis or iritis.

Why: e.g. flushing of the face with increases in skin temperature, acne-like rash over the face. May be complicated by blepharitis, conjunctivitis, episcleritis or corneal ulcers.

Why: e.g. watering eye, intense redness of the eye, scarring under the eyelids, ulcers on the surface of the eye, eyelid turn inwards and eyelashes scratch the surface of the eye. Trachoma is especially prevalent in outback areas and in aboriginal communities where hygiene may not be adequate.

Why: e.g. 24 hrs after the ingestion of contaminated meat may develop vomiting, diarrhea, abdominal pain and headache then may develop eyelid puffiness, conjunctivitis, photophobia (dislike of eyes for light), fever, muscle pain and muscle spasm.

Why: e.g. red hard lump at the bite site and enlarged local lymph nodes. If the portal of entry is the conjunctiva, may get unilateral puffiness of the eyelids, conjunctivitis and enlarged neck lymph nodes. May also have fever, transient rash and swelling of the face and trunk.