Differential Diagnosis for Left Lower Eye Swelling in a 12-Year-Old
Single Most Likely Diagnosis
- Allergic reaction or angioedema: This is a common cause of sudden onset swelling, especially if the child has a history of allergies. The lack of discomfort, redness, or vision changes and the description of the area as fluid-filled support this diagnosis.
Other Likely Diagnoses
- Periorbital cellulitis: Although the child denies discomfort and redness, periorbital cellulitis can present with swelling and should be considered, especially if there's any history of recent illness or sinus symptoms that might have been missed.
- Blepharochalasis or orbital fat prolapse: These conditions can cause swelling under the eye due to the herniation of orbital fat through a weakened orbital septum.
- Dacryocystitis: Inflammation of the lacrimal sac can cause swelling in the area under the eye, but it's usually accompanied by signs of infection like redness and discomfort.
Do Not Miss Diagnoses
- Orbital tumor (e.g., rhabdomyosarcoma): Although rare, orbital tumors can present with proptosis or swelling and must be considered to ensure timely diagnosis and treatment.
- Thyroid ophthalmopathy: This condition can cause swelling and proptosis due to autoimmune inflammation of the tissues around the eye, including fat and muscles.
- Cavernous sinus thrombosis: A life-threatening condition that can present with sudden onset of proptosis, swelling, and possibly vision changes, though the latter is not present in this case.
Rare Diagnoses
- Lymphangioma: A rare, benign tumor of the lymphatic vessels that can cause swelling in the orbit.
- Hemangioma: A benign vascular tumor that can present with swelling under the eye, though it's more commonly associated with a birthmark or discoloration.
- Sarcoidosis: A systemic disease that can affect the orbit and cause swelling, among other symptoms, though it's rare in children.