Abstract

SO.08.03

Persistent erythema and edema of the eyelids

Julia Lamparter, Ulrike Kottler, Norbert Pfeiffer, Susanne Pitz
Universitäts-Augenklinik Mainz

Objective
Morbus Morbihan is a rare disease which is characterized by persistent erythema and edema of the central and upper half of the face mainly restricted to the forehead, glabella, eyelids, nose or cheeks. It is thought to be a rare complication of rosacea and may lead to fibrotic induration. The characteristic features of this chronic disease are a typical clinical picture without any specific laboratory or histological findings and mostly resistance to clinical therapies.
Methods
A 53-year-old woman complained about a visual field-threatening erythematous edema of her eyelids for four years. The typical clinical picture and the exclusion of several differential diagnoses such as myxedema, chronic renal insufficiency or heart insufficiency led to the diagnosis of Morbus Morbihan. Oral rosacea therapy with doxycycline, metronidazole, isoretinoine and ketotifen was without any improvement. Therefore, we decided to perform an eyelid reduction surgery.
Results
Three months after the surgery an overall improvement in both visual fields and in cosmetic appearance was oberserved. Due to persistent edema the patient is now treated with topical steroid cream twice a day and lymphatic drainage therapy three times per week.
Conclusions
Morbus Morbihan is mostly resistant to clinical therapies. In our case an eyelid reduction surgery improved the cosmetic condition as well as the visual field defects.

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