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Dr. James
Dr. James, Board Certified Ophthalmologist
Category: Eye
Satisfied Customers: 2286
Experience:  Eye Physician and Surgeon
20222826
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I have had a swollen upper eye lid (only one eye) for the past

Resolved Question:

I have had a swollen upper eye lid (only one eye) for the past three months. The eye is almost completely closed. It does not hurt but the lid is a dark purple color. The eye itself is fine. I have seen two opthalmologists and am now seeing a dermatologist. They have irrigated the eye ducts and determined no obstruction. They have put me on antibiotics, taken a few biopsies, and a head scan--nothing problematic found. One opthalmologist thought it might be Wegener's disease but has dismissed that diagnosis. The only thing that has dramatically reduced the swelling has been steroids but it returns when I stop taking the medication. I am currently washing my face without soap and applying Hydrocortisone Butyrate 0.1%--still no change.

Any suggestions?
Submitted: 6 years ago.
Category: Eye
Expert:  Dr. James replied 6 years ago.

Dr. James :

Hello.

Dr. James :

Was it an MRI or CT scan?

Customer:

It was a CAT scan.

Dr. James :

Any pain?
Have you been on steroid pills?

Customer:

There is no paid. I am off the steroids for about three weeks. The

Customer:

symptoms returned the day I got off the steroids.

Dr. James :

Can you hold for one minute. I have to step away for just a moment.

Customer:

Sure.

Dr. James :

The next step should be an MRI. You may have a condition called idiopathic orbital inflammation. This is often treated with steroids, but sometimes it is important to get a biopsy.

Dr. James :

A MRI gives a much better picture than CT.

Dr. James :

If there is anything on MRI, then additional blood test to test for sarcoid or wegener's be necessary.

Dr. James :

Please let me know if you have any questions.

Customer:

I'll relay this message to the dermatologist. I think that you are probably on

Customer:

the right track. Thank you.

Dr. James :

Make sure the MRI is order for both the orbits with axial and coronal cuts.

Dr. James :

with and without contrast.

Dr. James :

You're welcome.

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