If you wake up in the morning with puffy eyelids, you need to differentiate between the different causes for better treatment. In the case of unilateral eyelid edema, the edema may be caused by insect bites, allergies, certain inflammatory conditions, or localized ophthalmic lesions. This requires a positive differential diagnosis for better treatment. In the case of bilateral eyelid edema, it may be caused by bilateral eye lesions or drinking too much water at night before going to bed. Ruling out the above causes would require ruling out systemic systemic diseases, most commonly renal disease. Kidney disease tends to present with bilateral eye swelling in the morning, as well as bilateral edema of the ankles, which can be accompanied by an increase in urine foam that does not disappear within a short period of time. If kidney disease is ruled out, there may be heart disease, such as heart failure, in which the patient may have palpitations after activity or inability to lie down at night. Ruling out cardiac and renal abnormalities, there may be abnormalities of the rheumatic system, endocrine system, and other systems that require different tests for differential diagnosis.