Periorbital oedema is swelling of the tissues around the eyes, particularly the eyelids and surrounding soft tissue. It can be unilateral or bilateral and may result from local eye conditions or systemic disease.
Causes
Local causes include eyelid inflammation, allergy, infection, trauma, or sinus disease, while systemic causes range from kidney or thyroid disorders to general fluid retention. The swelling may be puffy, red, or tender, or it may be soft and non-tender depending on the underlying mechanism.
- Acute onset with redness and pain can suggest infection or allergy
- Chronic, non-tender swelling may indicate systemic or structural causes
- Associated symptoms such as fever, rash, or breathing changes help narrow the diagnosis
- Visual changes or eye movement restriction are warning signs of deeper orbital involvement
Assessment and Management
Evaluation focuses on distinguishing benign, self-limiting causes from conditions requiring urgent treatment, such as orbital cellulitis or severe allergy. Management targets the underlying cause and may involve local measures, systemic therapy, or multidisciplinary input.
- History of recent infection, injury, or new medications is important
- Blood tests or imaging can be required to investigate systemic or orbital disease
- Cold compresses and elevation may help mild inflammatory swelling
- Prompt referral is essential if there is suspected orbital involvement or systemic compromise
