Differential Diagnosis for Periorbital Swelling
Single Most Likely Diagnosis
- Thyroid-Associated Orbitopathy: Given the patient's history of hypothyroidism, thyroid-associated orbitopathy is a strong consideration. This condition can cause periorbital swelling, exophthalmos, and eyelid retraction, which may result in the appearance of "huge bags" under and above the eyes.
Other Likely Diagnoses
- Allergic Rhinitis: Allergies can cause periorbital edema and puffiness, especially if the patient has a history of atopy or seasonal allergies.
- Fluid Retention: Hypothyroidism can lead to fluid retention, which may contribute to periorbital swelling.
- Aging and Gravity: As people age, the skin and tissues around the eyes can become thinner and more prone to sagging, resulting in the appearance of bags under the eyes.
Do Not Miss Diagnoses
- Orbital Cellulitis: Although less likely, orbital cellulitis is a serious infection that requires prompt treatment. It can cause periorbital swelling, redness, and pain, and can lead to serious complications if left untreated.
- Thyroid Storm: A life-threatening complication of untreated or undertreated hyperthyroidism, thyroid storm can cause periorbital swelling, among other symptoms.
- Wegener's Granulomatosis: A rare autoimmune disorder that can cause periorbital swelling, sinusitis, and other systemic symptoms.
Rare Diagnoses
- Sarcoidosis: A systemic granulomatous disease that can cause periorbital swelling, uveitis, and other ocular symptoms.
- Amyloidosis: A rare condition characterized by the deposition of abnormal proteins in various tissues, including the skin and orbit, which can cause periorbital swelling.
- Lymphoma: A type of cancer that can cause periorbital swelling, especially if it involves the orbit or lacrimal gland.