Differential Diagnosis for Bilateral Baggy Eyes

• Single most likely diagnosis
  • Hypothyroidism: This condition is often associated with periorbital edema, which can cause the appearance of baggy eyes due to the accumulation of mucopolysaccharides in the tissues around the eyes.
• Other Likely diagnoses
  • Allergic reactions: Allergies can cause edema and swelling around the eyes, leading to a baggy appearance.
  • Fluid retention: Conditions that lead to fluid retention, such as premenstrual syndrome or heart failure, can cause puffiness around the eyes.
  • Aging: As people age, the skin around the eyes can become thinner and less elastic, leading to a baggy appearance.
• Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
  • Thyroid eye disease: Although less common, thyroid eye disease can cause exophthalmos and periorbital edema, which may be mistaken for simple baggy eyes. Missing this diagnosis could lead to serious complications, including vision loss.
  • Nephrotic syndrome: This condition involves significant protein loss in the urine, leading to hypoalbuminemia, which can cause edema, including periorbital edema.
• Rare diagnoses
  • Wegener's granulomatosis: A rare autoimmune disorder that can cause inflammation and damage to various parts of the body, including the eyes, leading to periorbital edema.
  • Amyloidosis: A condition characterized by the deposition of amyloid proteins in various tissues, which can lead to periorbital edema and a baggy appearance around the eyes.