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Spontaneous periocular ecchymosis: a major review
Matthew J Hartley1, Pav Gounder2, Huw Oliphant2
1Newcastle Eye Centre, Royal Victoria Infirmary, Newcastle-Upon-Tyne, UK.
Orbit (Amsterdam, Netherlands)
|November 14, 2022
Summary
Spontaneous periocular ecchymosis (bruising around the eyes) can signal serious underlying conditions. This review highlights amyloidosis and neoplasms, particularly neuroblastoma, as frequent causes, emphasizing the need for thorough clinical evaluation.
Area of Science:
- Ophthalmology
- Neurology
- Oncology
Background:
- Periocular ecchymosis (bruising around the eyes) is common, typically due to trauma.
- Spontaneous periocular ecchymosis (SPE) is rare and can indicate complex underlying pathologies.
- Understanding the varied causes of SPE is crucial for accurate diagnosis and management.
Purpose of the Study:
- To review the literature on spontaneous periocular ecchymosis (SPE).
- To assess the frequency and variety of causes for this infrequent clinical finding.
- To enhance clinician understanding of SPE pathophysiology and etiology.
Main Methods:
- Literature review of 121 articles.
- Analysis of reported causes and frequencies of spontaneous periocular ecchymosis.
- Categorization of etiologies including neoplastic, vascular, and idiopathic causes.
Main Results:
- Amyloidosis (23%) and neoplasms (30%), notably neuroblastoma (17%), were the most common diagnoses associated with SPE.
- Raised intracranial pressure and vascular malformations accounted for 19% of cases.
- Migraine/headache disorders and iatrogenic causes represented smaller percentages (7% and 5%, respectively).
Conclusions:
- Spontaneous periocular ecchymosis necessitates a broad differential diagnosis, extending beyond trauma.
- Neoplastic and systemic conditions like amyloidosis are significant causes of SPE.
- Early identification of SPE etiology is vital for timely intervention, ranging from benign to life-threatening conditions.
