Puffy eyelid every morning/day

Ok, so about a year ago, I woke up with a puffy left eyelid and didn't really think much of it, and it was gone by the next day for the most part.  Nothing occured again for about a month or so, and then I had the same thing.  Now for the last 5 months or so, every morning that I wake up, my left upper eyelid is puffy and swollen like.  It doesnt hurt, it isnt itchy, it doesnt really get red, and it isnt particularly dry either (I do have dry skin around my nose and ears though, if it is connected), it is just puffy and swollen.  I saw an optometrist a while back and he said that it was blepharitis and said that daily warm compresses would help to control it.  He also prescribed me some Tobradex ointment to put on it as needed. The warm compresses didnt really help, it actually almost made it a little worse.  I had to and still use the tobradex ointment every morning to keep the swelling down (i know it is bad, but I am not going to go out with a huge eyelid every day).  I also went to an opthamalogist about 3 months after the optometrist and she told me that she thought it was allergies and prescribed my some allergy eye drops (bepreve I believe).  they also havent worked worth a damn, and I am still using tobradex.  It is only usually when i wake up in the morning that it is bad, as it tends to get a little bit better as the day goes on.  So anyway, that is why I am asking here now.  Is there anything I can do to get the puffiness to go down, any sort of doctor I should see that might be better at this thing??

Also, I realized that the symptoms really started to get bad when I started smoking marijuana.  I didn't do it when I originally got the puffiness a year ago, but I did smoke for about 5 months during which the symptoms gradually got worse.  I have since stopped and havent smoked for probably 1-2 months, but it hasn't gotten any better since I stopped.  I really regret smoking pot, but could this have had some effect on my eye problems?>

[Sandy Feldman, MD, MS]

Dear Tobra,

I would recommend that you seek the care of an eyeMD to determine the cause of the “puffiness”.  Tobradex contains a steroid which has potential side effects of glaucoma and cataracts. You should be monitored for these signs and also, obtain a different treatment, if possible.

Dr. Feldman

Sandy T. Feldman, M.D., M.S.
ClearView Eye and Laser Medical Center
San Diego, California