Periorbital edema

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Kiran Singh, M.D. [2] Luke Rusowicz-Orazem, B.S.

Overview

Periorbital edema refers to swelling around the eyes.

Causes

Common Causes

Causes by Organ System

Cardiovascular Cardiac failure, Congestive cardiac failure, Obstruction of the superior vena cava, Superior vena cava syndrome
Chemical/Poisoning Chemical burn, Tick bite on scalp, Insect bites
Dental No underlying causes
Dermatologic Dermatitis, Dermatomyositis, Discoid lupus, Sebaceous gland carcinoma, Thermal burn, Ultraviolet burn
Drug Side Effect Ingenol mebutate, Nabilone, Pramipexole, Sebelipase alfa, Steroids, Sulfasalazine
Ear Nose Throat Sinusitis
Endocrine Athyrotic hypothyroidism sequence , Hyperthyroidism, Hypoalbuminemia, Hypothyroidism
Environmental Insect bites
Gastroenterologic No underlying causes
Genetic No underlying causes
Hematologic Hematoma, Obstruction of the superior vena cava
Iatrogenic No underlying causes
Infectious Disease Acute dacryocytosis, Blepharitis , Chagas disease, Conjunctivitis, Dacryoadenitis, Dermatomyositis, Eyelid infection, Herpes simplex, Herpes zoster, Hibernian fever, Keratitis, Mononucleosis, Orbital cellulitis, Orbital inflammation, Periorbital cellulitis, Postinfectious glomerulonephritis, Sinusitis , Staphylococcal infection , Stye , Trichinella spiralis, Trichinosis
Musculoskeletal/Orthopedic Orbital bone trauma, Orbital cellulitis, Orbital cicarticial pemphigoid, Orbital disease, Orbital fat herniation, Orbital inflammation, Periorbital cellulitis
Neurologic Abnormal sleep length, Cavernous sinus syndrome polyneuropathy, Cavernous sinus thrombosis, Melkersson-rosenthal-schuermann syndrome
Nutritional/Metabolic No underlying causes
Obstetric/Gynecologic Menstruation, Pregnancy
Oncologic Sebaceous gland carcinoma, Squamous cell carcinoma, Tumors
Ophthalmologic Acute dacryocytosis, Blepharitis , Chalazion, Conjunctivitis, Dacryoadenitis, Eyelid infection, Keratitis
Overdose/Toxicity Excessive alcohol consumption, Excessive sodium consumption, Smoking
Psychiatric No underlying causes
Pulmonary No underlying causes
Renal/Electrolyte Excessive sodium consumption, Nephrotic syndrome, Postinfectious glomerulonephritis, Renal conditions, Renal failure
Rheumatology/Immunology/Allergy Allergies, Chronic cutaneous lupus erythematosus, Discoid lupus
Sexual Herpes simplex
Trauma Eye trauma, Head trauma, Hematoma, Herniated fat, Orbital bone trauma, Orbital fat herniation, Thermal burn, Tick bite on scalp, Ultraviolet burn
Urologic No underlying causes
Miscellaneous Aging

Causes In Alphabetical Order[1] [2]

Diagnosis

History and Symptoms

  • History includes:
  • Symptomatic history
  • Exposure history
  • Past medical history
  • Family history
  • Medicinal history

Eyes

  • Full opthamologic exam:
  • Chemosis
  • Cutaneous vesicles
  • Discharge
  • Erythmia
  • Proptosis
  • Tenderness

Laboratory Findings

  • Labs include:
  • Culture of eye

CT

  • CT of eyes, head and neck if deemed necessary

Echocardiography or Ultrasound

  • Consider echo if CHF is suspected

Other Diagnostic Studies

  • Consider biopsy of lesions if necessary

Treatment

  • Opthalmology consult

Acute Pharmacotherapies

  • Treat with topical antibiotics
  • If an allergy, remove allergen, add cold compress and antihistamines

References

  1. Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:77 ISBN 1591032016
  2. Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:68 ISBN 140510368X

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