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Dr. Rick
Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 11177
Experience:  Ophthalmology since 1994 with Retina sub-specialty interest
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persistent swelling of the conjunctiva of one eye..Only ice packs

Resolved Question:

Subsequent to upper and lower lid blepheroplasty four months ago, I have had persistent swelling of the conjunctiva of one eye. The condition has not improved with the use of corticosteroids or hypertonic drops. Only ice packs will somewhat reduce the swelling temporarily. There is only a slight tenderness when I rub the eye. The sclera of that eye was almost totally red for nearly a month after the surgery due to a hypodermic needle passing through a blood vessel during (according to the surgeon). What is the likely cause of the persistent swelling and will it likely resolve itself?
Submitted: 5 years ago.
Category: Eye
Expert:  Dr. Rick replied 5 years ago.

Dr. Rick :

Hi. I'm online and happy to answer your question today.

Dr. Rick :

One possible cause of this persistent swelling is prolapse of orbital fatty tissue due to a defect in your orbital septum.

Dr. Rick :

If it is still there and has been basically unchanging I would bet that is the cause.

Customer:

Would this prolapse be apparent in a visual examination of the eye and lids?

Dr. Rick :

yes, your eye doctor could easily see it with the slit lamp.

Dr. Rick :

You would just be able to see the swelling in the mirror not really tell what was causing it as the skin on your eye (conjunctiva) would cover the fatty tissue prolapse

Dr. Rick :

Does this make sense?

Customer:

My eye doctor has examined it with a slit lamp and didn't find any notable deformity. The swelling involves virtually the entire lower half of the scleral portion of the eye and is somewhat tinged red.

Dr. Rick :

Is your eye doctor an ophthalmologist (MD) or optometrist?

Customer:

Opthamologist

Dr. Rick :

Hmmmm......sounds like you may want to see another eye doc for a second opinion.

Dr. Rick :

If it was from the blood I would expect it to be resolved by this time

Customer:

Sadly, that was the second ophthalmologist's opinion. Neither ophthalmologist I have seen can determine an apparent cause.

Dr. Rick :

Now that is weird.......

Dr. Rick :

Well, the next step then is to bump it up to a corneal specialist. They are experts on diseases of the external eye. I was going to ask you to upload a picture but if two eye docs can't figure it out -- and they get to touch it and look at under high mag -- I doubt that a picture will help me :(

Dr. Rick :

I just can't imagine what undiagnosible condition, possibly related to your surgery could be causing this. Perhaps a biopsy is indicated....but I just can't think why....

Customer:

Thanks, XXXXX XXXXX Doc was a corneal specialist at the Cole Eye Institute in Cleveland and he only concluded that it would heal over time, but was not able to give cause. That was about a month ago and the condition has not improved. Grasping at straws.

Dr. Rick :

The Cole institute is an excellent place........at least at this point you can rest assured that is is nothing "terrible" (at least from disease point, not a cosmetic, of view)

Dr. Rick :

I'm sorry I don't have any good answers for you

Dr. Rick :

Is there anything else I can do for you today?

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