Q. Can a sinus infection cause puffiness in the lower eyelids?

Answered by
Dr. Sugreev Singh
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Nov 24, 2021

Hi doctor,

I suffer from sinus infections. I have recently been to an ENT for a second nose surgery as the first surgery did not fix my deviated septum properly. Over the past two months, I have had a sinus infection located directly behind the upper part of my nose.

I think that these infections are caused by dust or allergy. I have suffered from sinus issues for about four years now. But what I want to ask today is the reason for getting the puffy lower eyelids. It is starting to worsen, and I notice a puffy new patch developing below my left eyelid over my cheekbone. It looks like I have not slept for days when I wake. It is abnormally bloated. I recently started taking Pulmicort nasal spray. I have been taking it with Cetirizine, and it seems like the swelling has gone down, and my nose is feeling some relief. But my eyes are looking very ugly and bad still even though I have been getting sleep. Why is it so?

Should I take the antibiotic too? I always want only to use antibiotics as a last resort. How can you tell when to use it? If the Pulmicort makes it feel better should I hold off on the antibiotic?

Kindly help me know the cause of the issue and the tests that I need to do to fix my eyes.




Welcome to

Thank you for writing, and I can understand your concern.

Thank you for the detailed history. The main problem is sinusitis. So, if we treat the underlying infection and cause, then everything will get better.

Sinusitis and frequent infection can be either due to allergies like dust and pollen or infection. In your case, deviated nasal septum increases the risk of inflammation. Because when there is deviation, it leads to the formation of crust in the nose that stays for long and causes inflammation and swelling. So, the first thing you can do is reoperate it and get it corrected.

Another thing is using antibiotics, and the selection of antibiotics depends on the symptoms. If the symptoms are better with antihistamine and nasal spray, then antibiotics are usually not required. But it is not advisable to use the nasal spray for more than two weeks as it will lead to congestion. So in between, when you stop nasal spray, then use antibiotics to reduce the symptoms. But if symptoms are delicate or mild, then do not use.

Another way to prevent infection is to take proper precautions, such as wearing masks while cleaning the house or going out.

Take steam inhalation frequently. It will help in opening the sinus and reduce inflammation and swelling. About puffy eyes puffy, it is due to sinusitis. So, once the inflammation decreases, it will also go away.

Further testing required is an x-ray for the sinus to check if they are dilated or is there any fluid accumulation.

Would you please tell me since when you are taking Pulmicort (Budesonide)?

Would you please send a picture of your eye swelling?

Thank you.

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