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This question is for opthamologists. My wife woke up this

This question is for opthamologists. My...
This question is for opthamologists.
My wife woke up this morning with a badly swollen right eye. It does not look like a normal swollen eye. There is no discoloration in or around the eyeball. She was not drinking and did not have any less sleep than normal. There is a bag under the eye which feels like it might contain fluid. There is a slight bit of redness inside the lower eyelid. She has never had this before. What might this be? Is it something that would require a visit to an ER? Is it something a walk in clinic should be able to help? Is there some sort of home remedy?
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Answered in 2 minutes by:
12/9/2012
Dr. A.S. Desai
Dr. A.S. Desai, Ophthalmologist
Category: Eye
Satisfied Customers: 2,438
Experience: MS Ophthalmology with 13 years of surgical expereince
Verified
Dr. A.S. Desai :

Hello, Welcome to Pearl.com

Dr. A.S. Desai :

Are you available for chat now?

Customer:

Yes

Dr. A.S. Desai :

Does she have running nose/blocked nose/common cold? Did she blow her nose forcefully last night?

Customer:

No to all.

Dr. A.S. Desai :

Was there any injury to the eye or to the forhead ( like a bang on the forehead)?

Customer:

No. Nothing unusual happened

Dr. A.S. Desai :

Ok. Does the eye hurt at present? Is there tenderness at any spot on the eyelid?

Customer:

No pain. Bag may have fluid, but is not sensitive

Dr. A.S. Desai :

Sorry about so many questions....But I would like to know if she has any medical issues such as thyroid problem, diabetes, hypertension, any renal problems?

Customer:

She may be pre diabetic. Diabetes runs in her family, but she tests herself ever day.

Dr. A.S. Desai :

As the swelling has been of acute onset ( sudden) the chances of chronic systemic problems seems very unlikely. Being unilateral, painless, with normal vision, it is likely that it is due to pre-septal cellulitis. One of the possibilities is that of an allergy ( could be insect/ant bite).

Customer:

They have been painting the the catwalk and outside of our apartment building, but this has gone on for more than a week with no symptoms.

Dr. A.S. Desai :

Other conditions with such a swelling are escape of fluid due to rupture of the thin bone of the nose called ethmoid as can occur with forceful blowing of the nose. Swelling can occur following forehead injury which cause fluid to accumalate in the spongy tissue around the eyes. Since none of these events have occured , these are unlikely. A stye can also cause similar swelling but it would have been painful.

Dr. A.S. Desai :

Exposure to an allergen in the air would have caused swelling of both eyes and not just one side. Whereas an insect or ant bite would cause swelling on one side only.

Customer:

If it was an insect bite, how could we tell?

Dr. A.S. Desai :

Orbital cellulitis is considered a serious cause of swelling around the eye but it is characterised by swelling, pain, redness and reduced vision. Since the vision is not affected in her case, this possibility is very unlikely.

Dr. A.S. Desai :

An insect bite would have a bite mark around the eye/eyelid.

Customer:

There are no visible marks and no itching

Dr. A.S. Desai :

Nevermind, it can be difficult to identify at times. As long as the swelling is painless and the vision is normal, symptomatic treatment can be given to reduce the swelling.

Dr. A.S. Desai :

She can take Tab.Zyrtec(cetrizine) 10mg, one tablet at bedtime, for 4-5 days. She can apply cool compresses for symptomatic relief.

Customer:

Are the compresses the only immediate treatment?

Dr. A.S. Desai :

Compresses and Tab.Zyrtec would help.

Customer:

What could the underlying cause be?

Dr. A.S. Desai :

Could be allergy ( as in mild form of angioneurotic edema) or ant/insect bite.

Customer:

This has never happened before, and there are no apparent bites

Dr. A.S. Desai :

I understand that. Does she have any difficulty in breathing/constriction in the chest ?

Customer:

No other symptoms of any kind

Dr. A.S. Desai :

In that case it does not appear to be something which would require a visit to the ER. I would suggest that you try a course of Tab.Zyrtec and cool compresses for few days. In the meanwhile if symptoms worsen( occurance of pain/reduced vision or difficulty in breathing) or the swelling is persistent beyond 4-5 days of treatment, then do consult an ophthalmologist for a closer look.

Customer:

When should the Zyrtec and compresses begin to take effect?

Dr. A.S. Desai :

Within 4-5 days. It is gradual and not a rapid decrease( as in hours ) in the swelling.

Customer:

Are there any restrictions on her activity during this time?

Dr. A.S. Desai :

No, there are no restrictions.

Customer:

Could this be something that is contagious?

Dr. A.S. Desai :

Very unlikely to be so.

Customer:

OK Thanks

Dr. A.S. Desai :

You are welcome.

Dr. A.S. Desai :

Thank you and best wishes.

Please feel free to ask follow up questions, if any.

It was a pleasure to have answered this question.

Experts are credited only if a positive rating is given and not otherwise. So do remember to give your rating. A positive rating is what I aim for and we can continue to interact till you get a satisfactory response.A positive feedback and /or bonus are most welcome and appreciated.

Views expressed are for information purpose only and cannot substitute a visit to an ophthalmologist

Dr. A.S. Desai
Dr. A.S. Desai, Ophthalmologist
Category: Eye
Satisfied Customers: 2,438
Experience: MS Ophthalmology with 13 years of surgical expereince
Verified
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Dr. A.S. Desai, Ophthalmologist
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Satisfied Customers: 2,438
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Experience: MS Ophthalmology with 13 years of surgical expereince

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