Unilateral puffiness of the right upper eyelid is usually caused by eye diseases such as mydriasis, conjunctivitis and ocular trauma. In contrast, systemic diseases such as kidney disease often occur symmetrically in both eyes with symptoms of eyelid puffiness, but if the patient has eyelid oedema that often occurs early in the morning and is also associated with weight gain and sunken oedema elsewhere in the body, then kidney disease is considered and a visit to a nephrologist is recommended for examination.