If there is bilateral upper eyelid swelling that is noticeable in the early morning, precedes or manifests only as eyelid oedema, is accompanied by haematuria or recent sudden onset of hypertension, then a visit to a nephrologist is usually recommended to check kidney function to see if it is due to nephritis or nephrotic syndrome.
If lower limb oedema has been present for some time prior to the puffy eyes, it is more likely to be due to cardiac or liver disease and can also be checked first in cardiovascular medicine or hepatology.