Differential Diagnosis for Fall with Swelling Underneath Eye and Right Cheek

Single Most Likely Diagnosis

• Periorbital hematoma: This is the most likely diagnosis given the history of a fall and the presence of swelling underneath the eye, which is swollen shut. The swelling in the right cheek could be related to the trauma as well.

Other Likely Diagnoses

• Zygomaticomaxillary complex (ZMC) fracture: A fall could result in a fracture of the ZMC, leading to swelling and bruising in the cheek and underneath the eye.
• Orbital floor fracture: This type of fracture can occur from a fall and may cause swelling underneath the eye, as well as limited eye movement.
• Soft tissue injury: The swelling in the cheek and underneath the eye could be due to soft tissue injury, such as a contusion or laceration, from the fall.

Do Not Miss Diagnoses

• Cavernous sinus thrombosis: Although rare, this condition can occur after a facial injury and is life-threatening. Symptoms may include swelling and bruising around the eye, as well as neurological deficits.
• Retrobulbar hemorrhage: This is a medical emergency that can occur after a facial injury, causing increased pressure behind the eye and potentially leading to vision loss.
• Infection (e.g., orbital cellulitis): Infection can occur after a facial injury, especially if there is an open wound. It is crucial to monitor for signs of infection, such as increased redness, swelling, and fever.

Rare Diagnoses

• Brown syndrome: This is a rare condition that can cause limited eye movement and swelling underneath the eye, but it is not typically associated with trauma.
• Idiopathic orbital inflammatory disease: This is a rare condition that can cause swelling and inflammation in the orbit, but it is not typically associated with trauma.