Swollen eyes

[DocVikingo]

That the acute condition of eyes swollen shut was relieved so quickly upon ascent also struck me as odd.

Agree -- quite odd.

Regards,

DocVikingio

 

[PineNut]

A type I hypersensitivity should be considered (IgE mediated). Rubber accelerants, latex, thimerosal, etc. can perhaps be found on the surface of masks or in the anti-fog solution. Patch testing can be done and occasionally can pick up type I hypersensitivity along with the contact hypersensitivity it is designed to test for. Some folks are allergic to fragrances, formaldehyde, and formaldehyde releasers - all of which can be found in sun screen and other solutions as preservatives or additives. Sunscreens are strong eye irritants, and can also trigger rapid inflammatory response in the eye. Some sunscreen can cause contact allergy.

Perhaps using greater care with your sunscreen the next time such as not applying above the eyes, using spit for your antifogging solution, etc. can prevent this from happening. If it recurs, an appointment with either an allergist or dermatologist can be helpful for objective testing with either a patch test or intradermal test depending what they suspect.

 

[DocVikingo]

A type I hypersensitivity should be considered (IgE mediated). Rubber accelerants, latex, thimerosal, etc. can perhaps be found on the surface of masks or in the anti-fog solution.

Hi Pine Nut,

It would be quite atypical for a type I hypersensitivity reaction to present without pruritis or rubor and to resolve almost immediately after the dive. There also is no report of conjunctivitis which might be expected with a type I hypersensitivity reaction or other inflammatory response involving the eye.

Given a description of swollen eyes and distinct ruptured blood vessels in both eyes, the former which subsided soon after surfacing, mask squeeze is a much more likely diagnosis.

Regards,

DocVikingo

 

[PineNut]

Kind of a cool reaction.... But I said type I hypersensitivity should be considered. My son has peanut allergy, and his presentation is periorbital swelling with a high dose of peanut. No itching is noted. No urticaria has ever been noted. Pinprick test is positive, and IgE level is positive. Of course, he always carry an epipen.

Now he has "outgrown" it a bit.... Can tolerate about 1/4 of a nut at a time. The periorbital swelling has not occurred much since except once. Pruritus and urticaria has NEVER been manifested. Gas and digestive upset is usually the complaint. As far as I am concern, he still has type I hypersensitivity. We do not and can not expect type I hypersensitivity to present by the book.

Anyhow, consideration should be noted for type I hypersensitivity.... Unless you are a doctor who only practice from the book? Tunnel vision diagnosis only happens on TV and on Scubaboard.

 

[DocVikingo]

Well, you'll never be accused of that, Pine Nut. Was there any dermatological possibility you omitted in the following thread?:

Originally Posted by PineNut on 12.30.09 in response to "Painful Red Bumps just on palms of hands" Painful Red Bumps just on palms of hands

"To consider include:

1.Dyshidrosis or Dyshidrotic Eczema (Pompholyx)
2.Foreign body response to slivers of diatomaceous crystals from the sand
3.Irritant dermatitis or friction induced dermatitis from grabbing scuba tank or dive boat ladder
4.Contact allergic dermatitis of the palms or soles often result in a bumpy or clear pebbles under the skin
5.Friction induced urticaria, perhaps from the seafood you had the night before

If the lesions are found both on the hands and feet, then dyshidrosis, pustular psoriasis, and hand foot and mouth disease should be considered."

And

Originally Posted by PineNut on 12.31.09

"Other important differential to consider:

6. Perpetuation of an irritant dermatitis by a contact allergen (example topical neosporin, topical bacitracin, or topical diphenhydramine).

7. An unusual case of herpetic whitlow (where have you stuck your hand recently?? ) Just kidding, I was going to say up someone's ....."

Regards,

DocVikingo