Swelling of the eyelids

Synonym(s)

LIdödem; Lidoedema

Definition
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Polyätiological, acute or chronic, recurrent or persistent, painful or painless, red or non-red swelling of the eyelids.

Classification
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Acute eyelid edema:
- Allergic eyelid edema:
  - In type I sensitisation, e.g. against pollen, animal epithelia, house dust. Typical are the recurrent course as well as redness and itching after contact with allergens.
  - In type IV sensitization, e.g. contact allergy to cosmetics, shampoos, fragrances and medications (see also eczema, eyelid eczema).
- Toxic eyelid edema: due to contact with toxically active substances.
- Infectious, allergic or toxic conjunctivitis with reactive eyelid edema
- Angioedema
- Insect bites
- Reactive eyelid edema (collateral swelling of the eyelids): occurring in bacterial or allergic diseases of the capillitium, sinuses, teeth (dental abscesses).
- Infectious swelling of the eyelids: collateral swelling of the eyelids may occur with infectious iridocyclitis, conjunctivitis, blepharitis (e.g., hordeolum; herpes simplex infection, zoster, erysipelas).
Chronic eyelid edema:
- Position-dependent disorders (disorders of lymphatic drainage): Eyelid edema often worsens in prone position, drains in horizontal position.
- Blepharochalasis: eyelid bags due to sagging of the eyelid skin and bulging of the bulbar fat body.
- Rosacea (especially in the maximum variant of rosacea, Morbihan's disease)
- Chalazion
- swelling of the eyelids due to infiltrative growths of the eyelids (e.g. basal cell carcinoma, lymphoma)
- Lacrimal duct stenosis
- Sicca symptoms (dry eye): Drying out of the conjunctival surface (dry air, draughts, etc.) can cause foreign substances to penetrate the mucous membrane on the inside of the eyelid and thus lead to irritation of the eyelids with consecutive swelling of the eyelids.
- Endocrine orbitopathy (combined with exophthalmos)
- Dermatomyositis
- Systemic lupus erythematosus
- Sarcoidosis
- Retrobulbar ulcers
- Melkersson-Rosenthal syndrome (often unilateral)
- Leukemias/lymphomas
- Chronic nephropathies
- Heart failure
- Myxoedema
- Angiokeratoma corporis diffusum (Fabry disease).
Infectious diseases that may be associated with eyelid edema (rare in Europe):

Therapy
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Detection and elimination of the cause, if necessary careful internal or allergological clarification.
In case of morning swellings: cooling compresses, e.g. compresses soaked with black tea. Black tea bags are sufficient. After use, they should be cooled in the refrigerator while still wet and then placed on the eyelids for 5-15 minutes. Alternatively, "cool packs" are possible, as are cucumber slices.
Avoid smoke and alcohol in the evening.
In the case of non-allergic chronic swelling of the eyelids, special make-up techniques are recommended to cover the eyelids: dark colours "lower".
Eye bags can be removed surgically if necessary.