LAUSR

A 68-year-old woman presented with a 1-year history of swelling around both eyes. The swelling was not pruritic, but the patient reported a foreign body sensation and intermittent tear production. She had a history of asthma, allergies and bilateral upper lid blepharoplasty. She reported fatigue, and was found to have stable wheezing and a nonproductive cough. Physical examination revealed bilateral periorbital oedema without erythema, greatest in the infraorbital region and on the left side (Fig. 1). Investigation for thyroid abnormalities, angio-oedema, sarcoidosis and autoimmune conditions was negative. Computed tomography scan of the patient’s orbits and chest did not reveal any underlying neoplasm. The oedema worsened despite therapy with dexamethasone ointment followed by oral prednisone taper starting at 40 mg for 2 weeks and antihistamines, thus subtotal excisional biopsy of the left infraorbital region was performed by the Oculoplastic Service of our hospital.