What is the diagnosis for a periorbital hematoma (black eye) with swelling?

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Differential Diagnosis for Black/Swollen Eye

Single Most Likely Diagnosis

  • Periorbital Hematoma: This is the most likely diagnosis due to the common presentation of a black and swollen eye, often resulting from trauma, which can cause bleeding into the tissues around the eye.

Other Likely Diagnoses

  • Conjunctivitis: Inflammation or infection of the conjunctiva can cause swelling and redness around the eye, which might be perceived as blackness due to the discoloration.
  • Allergic Reaction: An allergic reaction can cause significant swelling and discoloration around the eye, often accompanied by itching and redness.
  • Cellulitis: A bacterial infection of the skin and tissues around the eye can lead to swelling, redness, and sometimes a black appearance due to the severity of the infection.

Do Not Miss Diagnoses

  • Orbital Cellulitis: Although similar to periorbital cellulitis, orbital cellulitis is an infection behind the eye, which can lead to serious complications, including vision loss and cavernous sinus thrombosis, if not promptly treated.
  • Retinal Detachment: Trauma to the eye can cause retinal detachment, which may present with symptoms like flashes of light, floaters, and a shadow or curtain descending over the field of vision, but can also cause swelling and discoloration around the eye.
  • Cavernous Sinus Thrombosis: A rare but potentially life-threatening condition that can arise from facial infections, including those around the eye, leading to thrombosis of the cavernous sinus.

Rare Diagnoses

  • Angioedema: A rare condition characterized by the rapid swelling of the dermis, subcutaneous tissue, mucosa, and submucosal tissues, which can affect the area around the eye and cause significant swelling and discoloration.
  • Wegener's Granulomatosis: A rare autoimmune disorder that can cause inflammation of the blood vessels, including those around the eye, leading to swelling and discoloration.
  • Melanoma: Although extremely rare to present as a swollen black eye, melanoma can cause pigmentation changes and swelling if it involves the tissues around the eye.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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