J Korean Ophthalmol Soc.  2015 Jan;56(1):119-123. 10.3341/jkos.2015.56.1.119.

A Case of Idiopathic Upper Eyelid Swelling Treated by Upper Eyelid Blepharoplasty

• Choi SK
• Ju LH
• Yum JH

• KMID: 2216164
• DOI: http://doi.org/10.3341/jkos.2015.56.1.119

Abstract

PURPOSE
To report a case of idiopathic upper eyelid swelling with minimal response to steroid treatment treated by upper eyelid blepharoplasty.
CASE SUMMARY
A 69-year-old man with diabetes mellitus and smoking history, presented upper eyelid swelling in both eyes starting 5 years ago. The patient had been receiving systemic steroid treatment for idiopathic upper eyelid swelling, though each attempt to taper steroid treatment led to recurrence of eyelid swelling. In the initial examination, both upper eyelids showed swelling. For differential diagnosis, a work-up including laboratory test and computerized tomography (CT) scan of the orbit were initiated. There were no abnormalities on laboratory tests including the thyroid function test. A CT scan of the orbit was unremarkable. For managing symptoms and inflammation, smoking was stopped and steroid treatment was administered. The patient still, however, complained of discomfort and swelling. To relieve symptoms and debulk inflammatory tissue, bilateral upper eyelid blepharoplasty was performed. The patient experienced reduced discomfort after the surgery. The biopsy showed no abnormalities, except for mild inflammation.
CONCLUSIONS
We present a case of idiopathic upper eyelid swelling despite steroid treatment. In this case, upper eyelid blepharoplasty was used with excellent functional and cosmetic outcomes. Thus, suspension of steroid treatment in cases of patients with recurrent eyelid swelling, in spite of steroid treatment, should be considered.

Keyword

Idiopathic upper eyelid swelling; Steroid-resistant upper eyelid swelling; Steroid side effect; Upper eyelid blepharoplasty

MeSH Terms

Aged
Biopsy
Blepharoplasty*
Diabetes Mellitus
Diagnosis, Differential
Eyelids*
Humans
Inflammation
Orbit
Recurrence
Smoke
Smoking
Thyroid Function Tests
Tomography, X-Ray Computed
Smoke

Figure

• 

  Figure 1. Clinical photographs of the patient's eyelid and axial view of orbit CT before starting treatment. (A, B) These pictures show bilateral eyelid swelling, especially in left upper eyelid. (C) CT showed only swelling of connective tissue of upper eyelid and there was no mass like lesion.

• 

  Figure 2. (A) Microscopic examination shows some interstitial hemorrhage and inflammatory cells in the eyelid tissue (Hematoxylin- eosin, ×400). (B) Hematoxylin and eosin stain shows clusters of fibroadiopse tissues in the preaponeurotic fat (×400).

• 

  Figure 3. Clinical photographs of the patient's eyelids. (A) After blepharoplasty at 3 months. (B) After blepharoplasty at 8 months. These pictures show decreased eyelid swelling.

Reference

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