Posters

Unilateral periorbital edema as preceded symptom of sarcoidosis

Poster Details

First Author: S.Moutzouri GREECE

Co Author(s):    E. Kanonidou                    

Abstract Details

Purpose:

To highlight the importance of a thorough multidisciplinary approach of a patient with unexplained unilateral periorbital edema.

Setting:

Department of Ophthalmology, Hippokration General Hospital of Thessaloniki, Thessaloniki, Greece

Methods:

A 38-year-old male with no previous history of ocular surgery or trauma presented to the ophthalmological emergency department with periorbital edema of the right eye over a few days. On examination discreet ipsilateral proptosis with erythema was noticed. His visual acuity was 10/10 bilaterally. Intraocular pressure, colour vision, pupillary reaction, ocular motility, fundoscopy, visual field examination, chest x-ray, dental and neurosurgical examination were unremarkable. Ear-nose-throat examination indicated sinusitis. Initial laboratory findings were within normal limits except for leukocytosis.

Results:

Computed tomography (CT) of the orbit and the face were performed, which manifested inflammatory stranding of the intraconal fat, enlargement of the extraocular muscles and sinusitis. The diagnosis of orbital cellulitis secondary to sinus disease was made and the patient was treated with broad spectrum antibiotics intravenously and nasal decongestant drops. Because of no clinical improvement the following days further investigation aided by a rheumatologist was performed. Chest CT manifested bilateral hilar lymphadenopathy and laboratory studies revealed elevated angiotensin-converting enzyme and hypercalciuria. The diagnosis of sarcoidosis was suspected and the patient was referred to pneumological clinic for further evaluation.

Conclusions:

Eyelid swelling can be the initial presenting sign of both infectious and non-infectious orbital inflammatory disease. A multidisciplinary approach is required to ensure timely diagnosis and treatment of the underlying cause.

Financial Disclosure:

None