Li, Sze Wai Rosa, Clancy, Noah, Intzedy, Laszlo, Stone, Natalie and Obi, Ebube
2025.
Unilateral peri-orbital oedema and mechanical ptosis: an unusual case presentation of rosacea.
Case Reports in Ophthalmology
16
(1)
, pp. 677-685.
10.1159/000548178
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Abstract
Introduction: Rosacea is an inflammatory skin condition that can present with varied ophthalmic manifestations. It is often overlooked by clinicians especially when unilateral in presentation leading to diagnostic delay and a resultant psychosocial impact. We aim to present a unique case of ocular rosacea, highlighting the difficulty in therapeutic challenges and diagnoses in such rare cases. Case report: A 64-year-old Caucasian man presented with a nine-month history of persistent painless swelling of the right upper eyelid and secondary ptosis. His ophthalmic examination, serology and MRI were otherwise normal besides mild meibomian gland dysfunction. Punch biopsy results were inconsistent and initially led to a misdiagnosis of benign squamous papillomata and later, a differential diagnosis of dermatomyositis. He was trialled on appropriate management for these conditions without any benefit. Repeat histopathology was suggestive of rosacea and given the persistence of symptoms despite multiple treatments, he was successfully managed with a right upper lid debulking biopsy transcutaneous blepharoplasty. Histopathological analysis of the debulking biopsy confirmed the diagnosis of rosacea, with additional features indicative of lymphoedema. Upon follow up, there was resolution of lid swelling. Conclusion: Due to the nonspecific nature of isolated ocular rosacea presentations, it can be easily misdiagnosed and therefore, should always be considered as a differential diagnosis in persistent peri-orbital oedema. It can additionally pose significant therapeutic challenges for ophthalmologists, underscoring the importance of improving our understanding of ocular rosacea. Further, we have shown the effectiveness of surgical debulking in its management.
| Item Type: | Article |
|---|---|
| Date Type: | Published Online |
| Status: | In Press |
| Schools: | Schools > Medicine |
| Publisher: | Karger Publishers |
| ISSN: | 1663-2699 |
| Date of First Compliant Deposit: | 9 September 2025 |
| Date of Acceptance: | 12 August 2025 |
| Last Modified: | 13 Oct 2025 15:15 |
| URI: | https://orca.cardiff.ac.uk/id/eprint/180875 |
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