Eyelid edema

Abstract

Facial aesthetic surgeons are sometimes challenged by the predicament of diagnosing and managing patients with chronic eyelid edema. Herein we provide a brief review of some of the more common causes of pre- and postoperative eyelid edema, many of which have important systemic implications, and offer management suggestions.

Keywords: Periorbital; edema; eyelid.

Figure 1

(A) Normal periocular aging changes. (B) Eyelid edema from chronic renal failure following three attempts at lower eyelid blepharoplasty and correction of lower eyelid retraction before referral. (C–E) Chronic eyelid edema secondary to systemic medical disease.

Figure 2

(A) Unilateral eyelid swelling with erythematous and translucent skin as well as conjunctival swelling (chemosis). (B) Eyelash ptosis of floppy eyelid syndrome with subtle preseptal eyelid edema in both upper and lower eyelids. (C, D) Atopic dermatitis with eyelid skin erythema, thickening, and lost elasticity leading to eyelid retraction. Note the characteristic vertically oriented rhytids. (E) Rosacea-associated posterior lid margin disease blepharitis with mild chemosis and attendant eyelid edema. Flash photography demonstrates a light reflex from chemosis at the eyelid margin in the left eye. (F) Nonflash photograph of same patient in (E) showing shadowing from the lower eyelid edema. (G) Deeply fissured tongue seen in Melkersson Rosenthal syndrome.

Figure 3

(A) Thyroid ophthalmopathy with three eyelid edema, chemosis, and upper eyelid retraction. (B) More subtle, previously undiagnosed thyroid ophthalmopathy and eyelid edema in a patient presenting for elective blepharoplasty. (C–E) Blepharochalasis syndrome with chronic eyelid changes of skin thinning narrowed horizontal fissures and loss of lateral canthal tendon fixation. (F) Chronic left upper eyelid edema and resultant blepharoptosis in a patient with previously undiagnosed inflammatory bowel disease-associated orbital inflammation. (G) Same patient as in (F) following blepharoplasty, blepharoptosis repair, and preseptal orbicularis myectomy.