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What can be done for black puffy eyes?

The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

Medically reviewed by

iCliniq medical review team

Published At July 16, 2018
Reviewed AtJuly 12, 2023

Patient's Query

Hello doctor,

I am 24, male and have been suffering from black puffy eyes for about three to four months now. It has got to the point where people have started noticing as it looks as if I am sick and tired. I have a healthy lifestyle and sleep seven to eight hours on an average. I never smoke and drink moderately like once a week. I did have a heavy coffee intake three to four months ago but I have stopped it completely. Stress wise, I am pretty chill and I do not think I have any serious stress in life right now. Healthwise, I have a deviated nasal septum and constant nose problems. My nose often gets dry and bleeds and I use saline nasal spray very often. I also take antihistamine tablets (Allegra 120 mg) on a daily basis.


Welcome to icliniq.com.

From from what you have told me and the photo of yourself (attachment removed to protect patient identity), I feel you have atopic conjunctivitis, a form of longstanding allergy. This is a problem which is related to the disease which you are experiencing in your nose and is essentially a form of the same disease in the eye. Although the disease is incurable, we can get the disease activity down to a level where it can not bother you in any way. For your problem of black and puffy eyes please do the following. Stop rubbing your eyes. This is the most important thing to stop your eyes from puffing up and getting darker. The main symptom of atopic conjunctivitis is itching. Itching causes the puffing of eyelids by increasing the allergic response and thickening the skin of your eyelid causing them to appear darker. Use anti-allergic eyedrops. The safest one being Olopatadine 0.1 % (generic name) twice a day or Olopatadine 0.2 % once a day. Although Olopatadine is a weak anti-allergic, it is the safest for long-term use. There are reports of people using them for years together every day with no problems. The action will take about two weeks from the start of treatment to take effect. Cold compresses to reduce eyelid puffing. Using ice packs over closed eyes can help reduce the puffing of your eyelids.

    The Probable causes


    Investigations to be done

    1.Skin pick test. 2.Slit lamp examination.

    Differential diagnosis

    1.Allergic conjunctivitis.

    2.Acute viral conjunctivitis

    Probable diagnosis

    Atopic conjunctivitis

    Treatment plan

    Anti-allergic eyedrops. Cold compresses. To stop eye rubbing.

    Preventive measures

    Stop eye rubbing.

    Regarding follow up

    For more information consult an eyecare ophthalmologist online.--->https://www.icliniq.com/ask-a-doctor-online/eye-care-ophthalmologist

    Same symptoms don't mean you have the same problem. Consult a doctor now!

    Dr. Manjunath Natarajan
    Dr. Manjunath Natarajan

    Ophthalmology (Eye Care)

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