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DIFFUSE EYELID DISEASE
1. Allergic
• Acute oedema
• Contact dermatitis
• Atopic dermatitis
• Blepharochalasis
2. Infections
• Preseptal cellulitis
• Herpes simplex
• Herpes zoster ophthalmicus
• Impetigo
• Erysipelas
• Necrotizing fasciitis
3. Miscellaneous
• Fat herniation
• Systemic causes
Acute allergic oedema
• Causes - insect bites, urticaria and angioedema
• Unilateral or bilateral
• Painless, red, pitting oedema
• Chemosis may be present
• Self-limiting
Contact dermatitis
• Sensitivity to topical medication
• Unilateral or bilateral
• Painless oedema and erythema
• Vesiculation and crusting
• Thickening if chronic
Atopic dermatitis
• Associated with asthma and hay fever
• Chronic itching and scratching
Facial - in young children Flexural - knees, elbows, wrists and ankles
Ocular associations of atopic dermatitis
Angular blepharitis Vernal disease in children
Thickening, crusting and
fissuring
Staph. blepharitis
Ocular associations of atopic dermatitis
Keratoconus
Keratoconjunctivitis
Shield - like cataract Retinal detachment
Blepharochalasis
• Uncommon, usually
bilateral
• Starts at about puberty
• Recurrent, non-pitting
oedema
• Usually upper eyelids
• Resolves after few days
• Complications - wrinkled,
thin skin and aponeurotic
ptosis
Preseptal cellulitis
Causes
• Skin trauma or insect
bites of lids or eyebrows
• Spread from local
infection
• Upper respiratory
or ear infection
Signs
• Usually unilateral
• Tender and red
• Periorbital oedema
Treatment - systemic
antibiotics
Herpes simplex
Signs
• Crops of small vesicles
• Rupture and crust
• Heal without scarring
after 7 days
Complications
• Follicular conjunctivitis
• Keratitis
Treatment - topical
antivirals
Herpes zoster ophthalmicus
• Crusting ulceration
Treatment - oral antivirals
• Painful vesicles and pustules
• Periorbital oedema - may be
bilateral
Impetigo
• Infection with Staph.
or Strep.
• Initially small vesicles
and bullae
• Later golden-yellow crusting
Treatment - topical and
systemic antibiotics
Erysipelas
• Staph. infection through
site of minor trauma
• Acute spreading cellulitis
• Well-defined, red, tender
subcutaneous plaque
Treatment - antibiotics
Necrotizing fasciitis
• Skin gangrene caused by
Staph. or Strep.
• Affects elderly or
debilitated
• May cause bilateral
lid necrosis
Treatment - surgical
debridement and systemic
antibiotics
Fat herniation
• Age-related,
usually bilateral
• Pockets of fat
herniating into
upper lids, especially
medially
Treatment
- blepharoplasty
Systemic causes of lid oedema
• Myxoedema
• Renal disease
• Congestive
heart failure
• Obstruction of
superior vena
cava
• Fabry disease

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diffuse eyelid diseases

  • 1. DIFFUSE EYELID DISEASE 1. Allergic • Acute oedema • Contact dermatitis • Atopic dermatitis • Blepharochalasis 2. Infections • Preseptal cellulitis • Herpes simplex • Herpes zoster ophthalmicus • Impetigo • Erysipelas • Necrotizing fasciitis 3. Miscellaneous • Fat herniation • Systemic causes
  • 2. Acute allergic oedema • Causes - insect bites, urticaria and angioedema • Unilateral or bilateral • Painless, red, pitting oedema • Chemosis may be present • Self-limiting
  • 3. Contact dermatitis • Sensitivity to topical medication • Unilateral or bilateral • Painless oedema and erythema • Vesiculation and crusting • Thickening if chronic
  • 4. Atopic dermatitis • Associated with asthma and hay fever • Chronic itching and scratching Facial - in young children Flexural - knees, elbows, wrists and ankles
  • 5. Ocular associations of atopic dermatitis Angular blepharitis Vernal disease in children Thickening, crusting and fissuring Staph. blepharitis
  • 6. Ocular associations of atopic dermatitis Keratoconus Keratoconjunctivitis Shield - like cataract Retinal detachment
  • 7. Blepharochalasis • Uncommon, usually bilateral • Starts at about puberty • Recurrent, non-pitting oedema • Usually upper eyelids • Resolves after few days • Complications - wrinkled, thin skin and aponeurotic ptosis
  • 8. Preseptal cellulitis Causes • Skin trauma or insect bites of lids or eyebrows • Spread from local infection • Upper respiratory or ear infection Signs • Usually unilateral • Tender and red • Periorbital oedema Treatment - systemic antibiotics
  • 9. Herpes simplex Signs • Crops of small vesicles • Rupture and crust • Heal without scarring after 7 days Complications • Follicular conjunctivitis • Keratitis Treatment - topical antivirals
  • 10. Herpes zoster ophthalmicus • Crusting ulceration Treatment - oral antivirals • Painful vesicles and pustules • Periorbital oedema - may be bilateral
  • 11. Impetigo • Infection with Staph. or Strep. • Initially small vesicles and bullae • Later golden-yellow crusting Treatment - topical and systemic antibiotics
  • 12. Erysipelas • Staph. infection through site of minor trauma • Acute spreading cellulitis • Well-defined, red, tender subcutaneous plaque Treatment - antibiotics
  • 13. Necrotizing fasciitis • Skin gangrene caused by Staph. or Strep. • Affects elderly or debilitated • May cause bilateral lid necrosis Treatment - surgical debridement and systemic antibiotics
  • 14. Fat herniation • Age-related, usually bilateral • Pockets of fat herniating into upper lids, especially medially Treatment - blepharoplasty
  • 15. Systemic causes of lid oedema • Myxoedema • Renal disease • Congestive heart failure • Obstruction of superior vena cava • Fabry disease