Definition

This refers to swelling of the eyelid due to abnormal collection of fluid in the subcutaneous tissue.

Epidemiology: Edema is a frequently encountered clinical symptom.

Etiology: The skin of the eyelid is affected intensively by infectious and allergic processes. With the upper eyelid's relatively thin skin and the loose struc ture of its subcutaneous tissue, water can easily accumulate and cause edema.

Symptoms: Depending on the cause (Table 2.2), the intensity of swelling in the eyelid will vary. The location of swelling is also influenced by gravity and can vary in intensity. For example, it may be more intense in the early morning after the patient rises than in the evening (Fig. 2.11).

Fig. 2.2 Differential diagnosis of edema

Criteria

Inflammatory edema

Noninflammatory edema

Symptoms

❖ Swelling

❖ Swelling

❖ Reddening

❖ Pale skin

❖ Sensation of heat

❖ Cool skin

❖ Painful

❖ Painless

❖ Usually unilateral

❖ Usually bilateral

Possible causes

❖ Erysipelas

❖ Associated with:

- paranasal sinus disorders

- orbital cellulitis

- dacryoadenitis

- dacryocystitis

❖ Systemic disorder:

- heart

- kidneys

- thyroid gland

❖ Allergy such as Quincke's edema

Fig. 2.11 With its relatively thin skin and its subcutaneous tissue that contains little fat, the upper eyelid is particularly susceptible to rapid fluid accumulations from pathologic processes.

2.5 Disorders of the Skin and Margin of the Eyelid

Table 2.2 shows the causes and differential diagnosis for inflammatory and noninflammatory edemas.

Treatment: This depends on the cause of the disorder.

Clinical course and prognosis: This depends on the underlying disorder.

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