A Red and Swollen Eyelid

Abstract

A woman in her 80s complained of fullness near her left eye for 2 months. She denied pain, trauma, or changes in vision. Her right eye had been enucleated 40 years before for choroidal melanoma, and she had been fitted with an ocular prosthesis (Figure 1). Twenty-six years before presentation, she was diagnosed with moderately differentiated, estrogen and progesterone receptor-positive, invasive ductal carcinoma of the left breast (Stage 2, T2, N1, M0). At that time, she underwent modified radical mastectomy, and three lymph nodes were positive for carcinoma. She was then treated with 6 cycles of cyclophosphamide, doxorubicin, and 5-fluorouracil, followed by daily tamoxifen for nearly 5 years. There was no evidence of recurrent disease after this treatment. External examination revealed mild edema, erythema, and ptosis of the left upper lid (Figure 1). Left cervical lymphadenopathy was present. Best-corrected visual acuity was 20/25, and left ocular motility was full. Figure 1 Erythema, edema, and ptosis of the left upper eyelid. Front (A), left (B), and right (B) aspects of the upper face show the ocular prosthesis (black arrowhead) and asymmetric enlargement, erythema, and ptosis of the left upper eyelid (white arrowheads). ...