ABSTRACT
A 31-year-old African-American woman with a medical history of well-controlled hypertension sought treatment for recurrent, monthly, unilateral orbital and subconjunctival hemorrhage for 1 year. The episodes were cyclical and coincided with the timing of her menstrual cycle. Examination findings included right periorbital fullness and subconjunctival hemorrhage. Extensive serologic and radiographic workup ruled out other potential causes of recurrent orbital hemorrhage. The patient was diagnosed with orbital vicarious menstruation and treated with oral contraceptive pills, with marked clinical improvement.
Subject(s)
Conjunctival Diseases/complications , Menstruation Disturbances/complications , Retrobulbar Hemorrhage/complications , Adult , Conjunctival Diseases/diagnosis , Conjunctival Diseases/drug therapy , Contraceptives, Oral, Combined/therapeutic use , Estrogens/therapeutic use , Ethinyl Estradiol/therapeutic use , Female , Humans , Levonorgestrel/therapeutic use , Menstruation Disturbances/diagnosis , Menstruation Disturbances/drug therapy , Retrobulbar Hemorrhage/diagnosis , Retrobulbar Hemorrhage/drug therapy , Visual AcuityABSTRACT
PURPOSE: The aim of this article was to report the clinical presentation, radiography, culture results, treatment modalities, and outcomes of periocular abscesses associated with brow epilation. METHODS: This was a retrospective case series including 26 patients referred for periocular abscess following brow epilation. RESULTS: Twenty-six female patients with a median age of 20.5 (range, 12-73) years were referred for oculoplastic evaluation of periocular abscesses related to recent brow epilation. All patients were treated with incision and drainage along with systemic antibiotics. Culture results revealed 16 cases of methicillin-resistant Staphylococcus aureus, 3 of methicillin-sensitive Staphylococcus aureus, and 7 cultures that showed no growth. All patients had resolution of their abscesses at 1-month follow-up visits without progression to orbital cellulitis. CONCLUSIONS: Periocular abscess formation after brow epilation has been previously described in only a single case report in the literature. The authors believe this entity is underreported given their current report describing 26 such cases. Given the high prevalence of cosmetic brow epilation in females, the authors believe a careful history regarding brow epilation in any patient presenting with a periocular abscess or preseptal cellulitis is essential to explore the possible cause of their infection. The majority of patients in the current study's cohort had methicillin-resistant Staphylococcus aureus-related abscesses, and treatment with antibiotics with methicillin-resistant Staphylococcus aureus coverage may be a prudent first line choice in such patients.
