Hello and thanks for your question. Are you available to chat?
How long have your eyelids been thick and puffy?
about 1 week
Do they seem boggy, like there is fluid in there or do they feel more leathery?
Do they itch at all? Do your eyes itch at all?
oddly, no itching, nor any general signs of allergy
Usually when the lids are boggy swollen there is some allergic component of the swelling. This usually responds well to cool compresses and 1% hydrocortisone ointment placed on them twice daily. If the are not red and itchy, you can probably hold on the ointment and just use the compresses and if they get red and itchy then start to use the ointment as well.
any possibility that there is infection?
If the lids are not red, tender, itchy or discharge present, then this is very likely not infectious.
OK. What do you make of that discoloration of my sclera?
How long has this been there?
It was noticed about a week ago. At the same time as the puffy lids. Initially there was a small bump there: http://www.flickr.com/photos/11182709@N00/5894402338/in/photostream/
Actually I got your link initially and have been examining the pictures. Great pictures! Thanks--it makes my job much easier. So do you think that this could've been there for much longer and you just didn't notice or are you fairly sure this popped up in the past week?
Fairly sure this just popped up because the discomfort prompted the examination.
(yw - made effort to take good pictures )
If it is that new then I would want to err on the side of caution and get it removed--surgery--excisional biopsy.
But as of today the bump seems to have disappeared. So would you exicise some of the discolored area?
I would elect to excise all of the discolored area.
ocular melanoma worries?
That is the ultimate concern. While the way it looks right now doesn't scare my pants off, the fact that has cropped up so extensively in such a short time, this makes me worried for malignancy.
yikes. what kind of problems could ensue from removing such a large area of the sclera
This is actually on the conjunctiva which is the thin, transparent skin overlying the sclera and which is usually fairly forgiving when a large piece is taken out. Although it looks very large, that amount is commonly removed, and if need be a little bit of conjunctiva from elsewhere on that eye or on the other eye can be transplanted in, if need be.
ok. any way to connect this to the puffy lid feeling since they came up around the same time?
No, they're about as unrelated as you can get, actually.
Will see a local opthamologist. Any addtl comments?
No, I think going to see your ophthalmologist is the right thing to do. While this isn't an emergency, I wouldn't wait several months to see that doctor either. Being as proactive as possible will put you in the best position possible. Do you have any other concerns that I haven't addressed?
You in California by any chance?
Actually, not far away, relatively. I'm in Oregon.
OK. One more thing - would it make any sense to wait a week or two and see whether this area is growing or shrinking by comparison to the photographs?
I don't think it would hurt you to wait a week or two, but I don't have any expectations of this pigmented area shrinking at all. They usually do not spontaneously resolve once they start.
OK. Thanks. That's all I can think of.
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