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Dr. Rick
Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 11414
Experience:  Ophthalmology since 1994 with Retina sub-specialty interest
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My eyes appear very bloated unattractive .the eyelids have

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my eyes appear very bloated unattractive .the eyelids have been swelling uo with sagging area under the eyebrows very puffy bloated area.
im on thyroxine 100mg
im trying to take metformin gradually for diabetes
im on statin daily
i have coeliac disease
ive been fr 2 eye tests no problems
other thing ive noticed is tension in the temple thininning of the skin undr the eyes and going dark.the whole area around my nose ,my eyes the eyelids are all swelled up and puffy.
i have severe tension and luks puffy the eyebrow area too basically all of the features around the nose .eyes eyebrosws eyelids all seem puffy and bloated what can it be ?
my ankles are puffy sometimes too and im very worried as sometimes i wake up and my eye luks very small as the eyelid is swollen etc /puffy what can it be im seeing my specialist again for the 3 rd time he doesnt know what it could be.hes my diabetic /thyroid specialist .ive gout an underactive thyroid im feeling tired and awful.
please can you suggest what i can ask mthe doc to luk investigate?
ive had sinus scan endoscopy all nasal areas seem clear and nothing . thanks
Dr. Rick :

Hi. I'm online and happy to answer your question today.

Dr. Rick :

It is possible that the swelling around your eyes is from orbital fat prolapse. This, of course, would not account for the issues around your ears and nose.


can you explain further what that exactly is ?

Dr. Rick :

Here is some information on how you can, at least, fix the problem around your eyes.

Dr. Rick : is some information.

Dr. Rick :

It sounds like you have orbital fat prolapse. This is a benign condition.

The most common cause of dark circles under the eyes is breakdown of the orbital septum which allows the normal orbital fat tissue that surrounds and cushions your eyeball to "pooch" forward.

As you know, there are tons of creams and lotions for the ladies to use for this issue. Why are there so many different ones? Because none of them work :-)

With age the thin, tough membrane (orbital septum) that keeps the normal fat pad in place behind your eye becomes weak and tears. When this happens you start to notice the swelling, or bags, under your eyes. It is nothing to worry about.

The only way to treat this problem is with surgery, called a blepharoplasty. Many times it can be done in a procedure room in the ophthalmologist’s office.

Here is a good webpage that discusses this surgery:

Dr. Rick :

Does this make sense to you?


Could it be the thyroxine? i discovered this morning that i was fine before i took this medicatn and after my head felt tense and my temples .i used to get like a burning ache at the back of my eyelid at the back of my eye at one time that has since gone but very specifically i feel theres bloating on my eyebrow area , nose , eyelid areas .


what do you think is it possible it could also be thyroxine casuing it ?


thanks i will read th link you sent and get back to you

Dr. Rick :

Not the thyroxin itself but maybe your thryoid functions are out of whack.

Dr. Rick :

A visit to your MD should be able to straighten that out if that is what is going on.

Dr. Rick :

Don't change your thyroxin dose yourself

Dr. Rick :

Are you still there.

Dr. Rick :

I guess you have stepped away from your computer

Dr. Rick :

I hope this information was helpful for you. But I do work for tips so I want to make sure you are happy with me before rating me. If you have another question on this or a related issue feel free to fire away. And please let me know if the rating system gives you any troubles.

Thanks in advance,

Dr. Rick

Customer: replied 4 years ago.


i was reading your link.I dont think i need surgery as the puffiness comes and goes away its something which has appreared with medication.

problem is i get bloated ankles too so im not sure what else i can say to the consultant as the recent tests for thyroid showed it was all ok

Are there any other testsi can request becasue i feel awful with swollen bloated half an upper face luks awful then my head constantly aches expecially when i have sugar so dont know what else i can ask the consultat tmrw ?

The thinning of the area and dark circles appeared when i took the thyroxine i could nt believe how apparent it all was.ii had no creases /wrinkles all of a sudden taking an increase in thyroxine my eyes luked bad ,dark /red blotches etc eyes skin texture changed very thin and i looked i had aged so much in a month .it must be the thyoxine i get tension and movements like cramps in my head and temples .then my eyes bloat etc


You are correct. If it comes and goes, it is not a surgical problem.
While there are no specific tests, a few blood tests looking for systemic problems such as thyroid issues, inflammation, evidence of systemic allergies etc might be helpful.
The thyroxine medication, if it is not at the correct level to replace what you need, could cause all sorts of problems. This is why your MD does thyroid levels to make sure. It probably wouldn't hurt to recheck your levels at this point from what you have posted.
I am happy to be able to help you today. If you would be so kind, please help me get credit for my efforts in answering your questions and press the excellent feedback button for this encounter. I would also be happy to continue to answer any more questions you have until we have resolved your concern.
Customer: replied 4 years ago.

Thank you for that.

Yes ,i should have mentioned they found in my blood tests inflammation raisers but cannot find where this is whats causing it ?

He actually increased my thyroxine from 75 mg to 100 mg and since hes done that i actually feel very tired like its not working at all.

They also found that cholesterol level was high so have put me on statin which i take during the day which i was quite shocked as i eat healthy gluten free and noone told me or put me on treatment until now although the problem was april 2012.

I am going to see my md this morning and i dont feel that ive been getting treatment as i should becasue hes put me on metformin half a tablet as my body jus would not take a whole 500 mg put me to sleep and every other week im stuck at home feeling tired run down and im a student i have to attend lectures for exams and i need to have some treatment concluded.

Hes a thyroid and diabetic specialist apparently but ive felt worst from medication hes trying on me and the doses that im in this state now.

Which is why i came to you for help to see if theres possible questions i could ask regarding the swelling around eyes nose eyebrow areas all very prominent.

The other thing to mention i i had nose surgery a few years ago which after gave me secretions for years ive had this problem and spasms in the nose to the point my nose is deformed and the secretions have nt stopped .i take nasal sprays but no good and that inside eye area / sides of nose / eyebrows i was thinking do i have a viral infection or could i take antibiotics jus incase it is ? would they harm me if i tuk them and it was nt an infection ?

Sorry to tell you all this but i think its impt you knw what the md has tested me for so we can rule these things out.

many thanks

Thank you for that additional information.
I am glad to hear that you will be going to see your MD this morning. Hopefully he can straighten these issues out.
But, perhaps, if this MD is not providing you with the care you think you need you should change doctors. There are many doctors out there and I'm sure you could find one that is a better fit.
Let me know how things turn out today.
I wish you the very best :-)
It's safe for you to press the positive feedback button now if you so desire. And, never fear, even after you press that button I don't go up in a puff of smoke -- I'll still be right here to continue helping you, but, as I do work for tips, I want to make sure you are happy before rating me.
Customer: replied 4 years ago.

Hello again

Ive been to see the MD

He thought it was 'daft' for me to mention that my thyroxine could be casuing my headaches ?

My argument was why i dont i feel its working anymre becasue instead of me feeling good with energy ,im doing the opposite crawling back into bed feeling tired etc

so hes told me to take thyroxine at night which i did last night so ive been awake all night not tired at all ??

he thinks i should weigh myslf in the morning and the evening to see whether i have water retension or something causing the inflammation ?

But did nt get any answers from him really i still feel its my thyroxine and i might have to change md to find out which is why i came to you so when i mentioned could it be possibly something attacking my thyroid gland and he said it was daft to think that ?

Hes not really a doctor who is looking at all the possibilities but i cant let this carry on as its FFACTING MY STUDIES, CAN YOU THINK OF ANYONE SPECIFICALLY I COULD APPROACH on this pls ?

many thanks

Hi May,
I'm sorry for the delay but my computer hard drive died and it has take me a while to buy a new one and re-install my entire system.....I ran into some glitches with my backup files :(
I'm sorry to hear about the problems you are having with this doctor. While he may be correct, and your issues might not be from your thyroxin just saying that you are "daft" does nothing to address your -- very real -- concerns.
At this point I think the best thing for you to do would be to gather up copies of all your medical records and travel to a large University Teaching hospital. At an institution like that you could be evaluated and treated by a team of sub-specialists who are at the cutting edge of their respective fields. The best thing about these large teaching hospitals is that consultations are available with Professors and leaders in their field by just walking a few steps down the hall.
The Mayo Clinic in Rochester, Minnesota is an excellent example of just such a place as this. That being said there are many excellent teaching hospitals all across the country and I am sure that there is one near you.
If you could tell me what large city you live near and how far it would be possible for you to travel in seeking treatment I would be happy to give you some names. Of course, you could also ask friends and associates or check the internet yourself. Let me know what you would like to do.
Does this answer your question to your satisfaction?
I hope this information was helpful for you. But I do work for tips so I want to make sure you are happy with me before rating me. If you have another question on this or a related issue feel free to fire away. And please let me know if the rating system gives you any troubles.
Thanks in advance,
Dr. Rick
Dr. Rick and other Eye Specialists are ready to help you
Customer: replied 4 years ago.

Thank you for your help Dr. Rick

Just to let you know i live in Cambridge uk England .

I went for a Diabetic eye test today everything is good there.

Do you think i should go and see my gp again maybe see if it could be something like a viral infection ?

the swelling is apparent only at the t-zone and temples nothing done near mouth etc

im just thinking is it worth asking for some anti biotics if they wont harm me is nt it worth it to try them just incase the swelling does go away.

becasue its my face i have nt been to uni looks puffy and awful but wehn i tell people they cant notice it they just notice when i tell them

Its my eyebrow bone area ,under myu eyes they look very hollow and aged all of a sudden and my forehead /temple has tension feels like sometimes i have cramps its distracted me i cant study.

in your opinion which type of specialist do you think i should see ?

a face specialis ?t thyroid ??

what do you think considering what ive told you about my head and tension etc etc

many thanks

Best Wishes

I glad that everything checked out on your diabetic eye exam.
I think a visit to your GP wouldn't hurt anything, although from what you have posted I do not think antibiotics are the answer.
Take care and have a good evening.