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Dr. Rick
Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 11313
Experience:  Ophthalmology since 1994 with Retina sub-specialty interest
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I my right eye is puffy and swollen. most of the swelling is

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Hi I my right eye is puffy and swollen. most of the swelling is under the eye. it feels like the tear duct is blocked?

Hi. I'm online and happy to answer your question today.
How long has this been going on for?
Is there a focal tender spot at all?
Is just your lower lid and the area under one eye involved or does this affect a larger area?
Do you wear contacts?
Could you take a picture and upload it so I can take a look?
Here is how you can upload a picture to me easily:
Save your picture on your computer, someplace easy to find it such as your desktop.
Go to
Upload your picture to the site by browsing for it as directed.
This opens up files on your computer. Double click on the picture you want to upload then hit open (bottom right of the screen). This will take you back to the tinypic page. Hit "upload now" then do the secret code thing and your picture will upload into the system.
Once you do that it gives you a bunch of links you can use, one of which says "direct link for layouts" It is important to use this box. It is the forth one down from the top of the page.
Copy the link from inside this box and then paste it into your justanswer dialog box and send it to your expert.
This is not an answer, but an Information Request. I need this information to answer your question. Please reply, so I can answer your question. I look forward to helping you.
Customer: replied 4 years ago.

hello, I don't wear contacts. it has been going on for about 2 days. last night before I went to bed I took a hot shower and put the washcloth over my eye, and it seemed to help the swelling go down. then when I woke up this morning it was all puffy again. it also feels like when you get the "sand from the sandman" in your eyes, that's what it feels like in my right eye.

Customer: replied 4 years ago.

I cant get the pic to down load

Ok. Don't worry about it. We can do this without the picture.
I think I know what is going on. The good news? There is something you can do at home to make things better. Let me tell you about this:
It sounds like you are suffering from an anterior segment/tear film issue. Many times, for all sorts of reasons, the anterior surface of the eye starts to have difficulties. What can cause this? Well, there are a number of conditions but the most common are dry eyes, allergies and blepharitis....many times all three conditions act together to make you miserable. In order to solve your problem you need to address all of these issues at the same time.
When it comes to allergies it is almost impossible to pin down the offending agent(s) and, therefore, treatment needs to focus on controlling the symptoms. Dry eyes are very common and can be improved by a stepwise series of therapies. First, the use of natural tears 4-6+ times/day to augment your natural tear production, if this doesn’t work then you can try temporary punctal occlusion of the lower puncta, then, if needed, temporary occlusion of all 4 puncta then, if indicated, surgical ( non-reversible) closure of the puncta. The openings to your tear drainage system are called puncta and you have one opening on each lid, near your nose.
Blepharitis is a condition where glands in the eyelids are not functioning normally. They become plugged and instead of putting out their normal clear, oily secretions, they put out thick, toothpaste like gunk. You may not be able to see this “gunk” yourself, unless it is really bad, but it shows up clearly on slit lamp examination.
The best treatment for this condition daily lid scrubs combined with warm compresses. I like to use baby shampoo for lid scrubs. In the shower, place the shampoo on your index fingers, close your eyes, raise your eyebrows (to stretch the skin on your eyelids) and scrub back and forth along your eyelashes for 3 to 5 minutes. The hot water in the shower helps to soften the plugged oils in the glands while the mechanical scrubbing with your soapy fingers removes the oils.
Baby shampoo lid scrubs will also help to wash away allergens and stimulate tear production, thereby addressing all three of your issues. Remember, this is not an instant fix. While you are waiting for the lid scrubs to have affect you can use over the counter allergy pills such as Travist, dimetapp or Zyrtec.
Should your symptoms get worse, your vision become significantly affected or things just not get better in 3 weeks or so you should have a complete eye examination by your local ophthalmologist to look for other, less common, causes of your symptoms.
I understand that this treatment seems a bit "too low tech" to be of value, but after 2 decades of clinical practice, I can assure you (even from personal experience :) that it, does indeed, work.
Now. You might wonder how it is that only one eye is affected. Well I'll tell you why:
I don't know ;)
But it happens this way a lot...
Is there anything else you would like to discuss at this point or have all your questions been answered 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. You may also receive an email survey after our chat, if you don’t feel that I have earned a “10” rating in all areas, please let me know what I can do to meet your expectations.
Thanks in advance,
Dr. Rick MD FACS
I hope you feel better soon.
Customer: replied 4 years ago.

would this have happened from the worst cold I ever had that I am getting over now?

Since it seems you have come up with part of the answer yourself does that mean we should split the reward? lol!
The lid scrubs,warm compresses and artificial tears will help your eye to feel better even if this is all from that nasty cold you are just getting over.
Take care and have a good evening.
Customer: replied 4 years ago.

ok, cool, thanks Dr. Rick. Have a good night.

You too.
Don't forget to mash the excellent feedback button for me....
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