Puffy Eyes

I work at a DME, I have a patient complaining of puffy eyes.
I went through the usual leakage checks, humidity checks.
This patient has little to no leakage and has been on the same pressure for years,
complains that eye brow down eyes are swollen and puffy.

any info or advice?

Thanks

Which mask are they using?

Nuance pillows

Take a look where here straps are in relation to her eyes. See if you can find a different nasal pillow mask with less strap presence anywhere near the eyes. ResMed P10 with some strap covers might be an option. Minimal straps around the eyes.

Puffy eyes...bags under the eyes, etc...that's normal body fluids that get pooled in an area because something is restricting the normal dispersal. Mask straps are notorious for applying pressure across the cheeks under the eyes so that fluids don't disperse and they accumulate and we get bags under the eyes or puffiness around the eyes.

Alternately you might see if you can put some sort of strap wrap on the part of the strap that is near the eyes. Some padding to help diffuse the pressure of the strap on the skin.
Also might see if you can loosen the straps a little but IMHO and from past experience...this doesn't work out so great because of the leaks that happen when straps are too loose.

I always had to use some sort of strap cover going across the part of the strap that is near my eyes and even then I would sometimes still get bags under my eyes and my straps have always been notoriously loose. Some people just get bags or puffiness from the fluids more than other people. I Finally went to the Bleep nasal mask....no headgear and not straps....no more bags under my eyes ....ever.
See the link in my profile for what it looks like.

Unexplained puffiness would get me to make an appointment with a cardiologist.
It's not always cpap--coincidences happen.