Periorbital edema

Overview
Periorbital edema refers to swelling around the eyes.

Differential Diagnosis
In alphabetical order:


 * Acute dacryocytosis
 * Aging changes
 * Allergy
 * Blepharitis
 * Cardiac failure
 * Chalazion
 * Chemical burn
 * Contact dermatitis
 * Dacryoadenitis
 * Dermatitis
 * Dermatomyositis
 * Discoid lupus
 * Herpes Simplex
 * Herpes Zoster
 * Hypothyroidism
 * Nephrotic Syndrome
 * Orbital Disease
 * Orbital fat herniation
 * Orbital cicarticial pemphigoid
 * Preseptal/periorbital cellulitis
 * Renal Failure
 * Sebaceous gland carcinoma
 * Squamous or basal cell carcinoma
 * Superior Vena Cava Syndrome
 * Thermal burn
 * Trauma
 * Ultraviolet burn

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:
 * Albumin
 * ANA
 * BUN / Creatinine
 * CBCD
 * ESR
 * TSH
 * Urinalysis


 * Culture of eye
 * Gram stain if suspected infection

MRI and 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