Periorbital edema: Difference between revisions

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{{Infobox_Disease |
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==Overview==
==Overview==
'''Periorbital edema''' refers to swelling around the eyes.
'''Periorbital edema''' refers to swelling around the eyes.


== Differential Diagnosis ==  
==Causes==
 
<div style="-webkit-user-select: none;">
In alphabetical order: <ref>Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:77 ISBN 1591032016</ref> <ref>Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:68 ISBN 140510368X</ref>
===Common Causes===
 
*Acute dacryocytosis
*Acute dacryocytosis
*Aging changes
*Aging changes
Line 37: Line 21:
*[[Dermatomyositis]]
*[[Dermatomyositis]]
*[[Discoid lupus]]
*[[Discoid lupus]]
*[[Drugs]]
*[[Herpes Simplex]]
*[[Herpes Simplex]]
*[[Herpes Zoster]]
*[[Herpes Zoster]]
Line 46: Line 31:
*Preseptal/periorbital [[cellulitis]]
*Preseptal/periorbital [[cellulitis]]
*[[Renal Failure]]
*[[Renal Failure]]
*Sebaceous gland carcinoma
*Sebaceous gland [[carcinoma]]
*Squamous or [[basal cell carcinoma]]
*Squamous or [[basal cell carcinoma]]
*[[Superior Vena Cava Syndrome]]
*[[Superior Vena Cava Syndrome]]
Line 52: Line 37:
*[[Trauma]]
*[[Trauma]]
*Ultraviolet burn
*Ultraviolet burn
===Causes by Organ System===
{|style="width:80%; height:100px" border="1"
|style="height:100px"; style="width:25%" border="1" bgcolor="LightSteelBlue" |'''Cardiovascular'''
|style="height:100px"; style="width:75%" border="1" bgcolor="Beige" | [[Cardiac failure]],  [[Congestive cardiac failure]],  [[Obstruction of the superior vena cava]],  [[Superior vena cava syndrome]]
|-
|bgcolor="LightSteelBlue"| '''Chemical/Poisoning'''
|bgcolor="Beige"| [[Chemical burn]],  [[Tick bite on scalp]], [[Insect bites]]
|-
|-bgcolor="LightSteelBlue"
| '''Dental'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Dermatologic'''
|bgcolor="Beige"| [[Dermatitis]],  [[Dermatomyositis]],  [[Discoid lupus]],  [[Sebaceous gland carcinoma]],  [[Thermal burn]],  [[Ultraviolet burn]]
|-
|-bgcolor="LightSteelBlue"
| '''Drug Side Effect'''
|bgcolor="Beige"| [[Ingenol mebutate]],  [[Nabilone]],  [[Pramipexole]],  [[Sebelipase alfa]],  [[Steroids]],  [[Sulfasalazine]]
|-
|-bgcolor="LightSteelBlue"
| '''Ear Nose Throat'''
|bgcolor="Beige"| [[Sinusitis]]
|-
|-bgcolor="LightSteelBlue"
| '''Endocrine'''
|bgcolor="Beige"| [[Athyrotic hypothyroidism sequence ]],  [[Hyperthyroidism]],  [[Hypoalbuminemia]],  [[Hypothyroidism]]
|-
|-bgcolor="LightSteelBlue"
| '''Environmental'''
|bgcolor="Beige"| [[Insect bites]]
|-
|-bgcolor="LightSteelBlue"
| '''Gastroenterologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Genetic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Hematologic'''
|bgcolor="Beige"| [[Hematoma]],  [[Obstruction of the superior vena cava]]
|-
|-bgcolor="LightSteelBlue"
| '''Iatrogenic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Infectious Disease'''
|bgcolor="Beige"| [[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]]
|-
|-bgcolor="LightSteelBlue"
| '''Musculoskeletal/Orthopedic'''
|bgcolor="Beige"| [[Orbital bone trauma]],  [[Orbital cellulitis]],  [[Orbital cicarticial pemphigoid]],  [[Orbital disease]],  [[Orbital fat herniation]],  [[Orbital inflammation]],  [[Periorbital cellulitis]]
|-
|-bgcolor="LightSteelBlue"
| '''Neurologic'''
|bgcolor="Beige"| [[Abnormal sleep length]],  [[Cavernous sinus syndrome polyneuropathy]],  [[Cavernous sinus thrombosis]],  [[Melkersson-rosenthal-schuermann syndrome]]
|-
|-bgcolor="LightSteelBlue"
| '''Nutritional/Metabolic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Obstetric/Gynecologic'''
|bgcolor="Beige"| [[Menstruation]],  [[Pregnancy]]
|-
|-bgcolor="LightSteelBlue"
| '''Oncologic'''
|bgcolor="Beige"| [[Sebaceous gland carcinoma]],  [[Squamous cell carcinoma]],  [[Tumors]]
|-
|-bgcolor="LightSteelBlue"
| '''Ophthalmologic'''
|bgcolor="Beige"| [[Acute dacryocytosis]],  [[Blepharitis ]],  [[Chalazion]],  [[Conjunctivitis]],  [[Dacryoadenitis]],  [[Eyelid infection]],  [[Keratitis]]
|-
|-bgcolor="LightSteelBlue"
| '''Overdose/Toxicity'''
|bgcolor="Beige"| [[Excessive alcohol consumption]],  [[Excessive sodium consumption]],  [[Smoking]]
|-
|-bgcolor="LightSteelBlue"
| '''Psychiatric'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Pulmonary'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Renal/Electrolyte'''
|bgcolor="Beige"| [[Excessive sodium consumption]],  [[Nephrotic syndrome]],  [[Postinfectious glomerulonephritis]],  [[Renal conditions]],  [[Renal failure]]
|-
|-bgcolor="LightSteelBlue"
| '''Rheumatology/Immunology/Allergy'''
|bgcolor="Beige"| [[Allergies]],  [[Chronic cutaneous lupus erythematosus]],  [[Discoid lupus]]
|-
|-bgcolor="LightSteelBlue"
| '''Sexual'''
|bgcolor="Beige"| [[Herpes simplex]]
|-
|-bgcolor="LightSteelBlue"
| '''Trauma'''
|bgcolor="Beige"| [[Eye trauma]],  [[Head trauma]],  [[Hematoma]],  [[Herniated fat]],  [[Orbital bone trauma]],  [[Orbital fat herniation]],  [[Thermal burn]],  [[Tick bite on scalp]],  [[Ultraviolet burn]]
|-
|-bgcolor="LightSteelBlue"
| '''Urologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Miscellaneous'''
|bgcolor="Beige"| [[Aging]]
|-
|}
===Causes In Alphabetical Order<ref>Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:77 ISBN 1591032016</ref> <ref>Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:68 ISBN 140510368X</ref>===
*[[Abnormal sleep length]]
*[[Acute dacryocytosis]]
*[[Aging changes]]
*[[Allergies]]
*[[Athyrotic hypothyroidism sequence ]]
*[[Blepharitis ]]
*[[Cardiac failure]]
*[[Cavernous sinus syndrome polyneuropathy]]
*[[Cavernous sinus thrombosis]]
*[[Chagas disease]]
*[[Chalazion]]
*[[Chemical burn]]
*[[Chronic cutaneous lupus erythematosus]]
*[[Congestive cardiac failure]]
*[[Conjunctivitis]]
*[[Dacryoadenitis]]
*[[Dermatitis]]
*[[Dermatomyositis]]
*[[Discoid lupus]]
*[[Ent tumour]]
*[[Excessive alcohol consumption]]
*[[Excessive sodium consumption]]
*[[Eye trauma]]
*[[Eyelid infection]]
*[[Head trauma]]
*[[Hematoma]]
*[[Herniated fat]]
*[[Herpes simplex]]
*[[Herpes zoster]]
*[[Hibernian fever]]
*[[Hyperthyroidism]]
*[[Hypoalbuminemia]]
*[[Hypothyroidism]]
*[[Ingenol mebutate]]
*[[Insect bites]]
*[[Keratitis]]
*[[Melkersson-rosenthal-schuermann syndrome]]
*[[Menstruation]]
*[[Mononucleosis]]
*[[Nabilone]]
*[[Nephrotic syndrome]]
*[[Obstruction of the superior vena cava]]
*[[Orbital bone trauma]]
*[[Orbital cellulitis]]
*[[Orbital cicarticial pemphigoid]]
*[[Orbital disease]]
*[[Orbital fat herniation]]
*[[Orbital inflammation]]
*[[Periorbital cellulitis]]
*[[Postinfectious glomerulonephritis]]
*[[Pramipexole]]
*[[Pregnancy]]
*[[Renal conditions]]
*[[Renal failure]]
*[[Sebaceous gland carcinoma]]
*[[Sebelipase alfa]]
*[[Sinusitis ]]
*[[Smoking]]
*[[Squamous cell carcinoma]]
*[[Staphylococcal infection ]]
*[[Steroids]]
*[[Stye ]]
*[[Sulfasalazine]]
*[[Superior vena cava syndrome]]
*[[Tear glands]]
*[[Thermal burn]]
*[[Tick bite on scalp]]
*[[Trauma]]
*[[Trichinella spiralis]]
*[[Trichinosis]]
*[[Tumors]]
*[[Ultraviolet burn]]
</div>


== Diagnosis ==  
== Diagnosis ==  
=== History and Symptoms ===  
=== History and Symptoms ===  
*History includes:
*History includes:
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:*[[Gram stain]] if suspected infection
:*[[Gram stain]] if suspected infection


=== MRI and CT ===  
=== CT ===  
*CT of eyes, head and neck if deemed necessary
*CT of eyes, head and neck if deemed necessary


Line 94: Line 268:


== Treatment ==
== Treatment ==
*opthalmology consult  
*Opthalmology consult  


=== Acute Pharmacotherapies ===  
=== Acute Pharmacotherapies ===  
Line 103: Line 277:
{{Reflist}}
{{Reflist}}


{{SIB}}


[[Category:Opthalmology]]
 
[[Category:Ophthalmology]]
[[Category:Medical signs]]
[[Category:Symptoms]]
[[Category:Signs and symptoms]]
[[Category:Signs and symptoms]]
[[Category:Nephrology]]
[[Category:Nephrology]]

Latest revision as of 20:06, 12 January 2017

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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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