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Rachel K. Sobel, Keith D. Carter, Richard C. Allen; The Differential Diagnosis and Classification of Periorbital Edema. Invest. Ophthalmol. Vis. Sci. 2012;53(14):1023.
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To retrospectively review the causes of eyelid swelling in a tertiary care oculoplastics service and to devise an algorithm from these cases to help with the diagnostic challenge of eyelid swelling
A retrospective case review was performed of all new patients who presented to the University of Iowa Oculoplastic clinic with the chief complaint of eyelid swelling from September 2009 through November 2011. Patients with known thyroid eye disease, with focal swelling (ex. chalazion, cysts) or with unknown diagnoses were excluded
Thirty-five cases of periorbital edema were identified. The most common reason was orbital mass (9). These included lymphoma, schwannoma, lymphangioma, capillary hemangioma, mucocoele, and eosinophlic granuloma. Next was thyroid eye disease (7) and dacryoadenitis (7). Other etiologies included: dermatitis (5) other (3) (prominent brow, brow ptosis, s/p craniotomy and radiation), drug-induced (2) (Actos, trial off Lamictal in progress), autoimmune (ANCA+vasculitis) (1), and xanthogranulomatous disease (1). For diagnosis, fourteen patients obtained CT scan, 5 obtained MRI, another 5 obtained both CT and MRI. Thirteen patients required biopsy.
Periorbital eyelid edema can confound even seasoned practitioners. This case review reveals the variety of etiologies that cause edema. An algorithm is created from these cases to assist in navigating the broad differential for eyelid edema.
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