Disease	Pathophysiology	Signs and symptoms
Superficial skin processes
Atopic dermatitis	Skin manifestation of systemic allergic sensitivity	Raised, dry plaque
Basal cell carcinoma	Neoplastic changes	Raised, umbilicated lesion with overlying telangiectasia
Capillary hemangioma	Localized growth of capillaries	Flat or raised well-circumscribed erythema; increases in size with crying
Contact dermatitis	Local reaction to irritative agent	Irritation, erythema, and edema
Herpes zoster ophthalmicus	Varicella zoster virus infection	Vesicles with surrounding erythema, possible bacterial superinfection; distributed unilaterally on forehead and upper eyelid in a dermatome
Periorbital ecchymosis (“black eye”)	Blunt trauma to orbit resulting in disruption of blood vessels	Ecchymosis increasing in size over 48 hours, then slowly improving
Squamous cell carcinoma	Neoplastic changes	Painless erythematous flaky plaques, nodules, or ulcers
Inflammatory eyelid processes
Blepharitis	Inflammation of the base of the eyelashes and/or distal aspects of the eyelids; inflammation of the lacrimal gland	Irritated lid edges or eyelash
Chalazion	Noninfectious obstruction of meibomian tear gland	Discrete mass within the lid present for two or more weeks
Dacryoadenitis	Inflammation of the lacrimal gland	Circumscribed tender mass in upper outer lid; if advanced, may appear as the diffuse inflammation of preseptal cellulitis
Dacryocystitis	Inflammation of the lacrimal sac and duct	Tender mass at the medial aspect of the lower eyelid; if advanced, may appear as the diffuse inflammation of preseptal cellulitis
Hordeolum or stye	Hordeolum: infection of the meibomian (sebaceous) glands	Papule or furuncle at distal lid margin
	Stye: infection of the sweat gland (gland of Zeis) of the eyelid
Local infections
Orbital cellulitis	Infection of the soft tissues within the orbit, posterior to the orbital septum, often due to spread from local sinus disease	Red, swollen, tender eyelid; extraocular movements limited because of pain or muscle edema; vision changes, diplopia; in children, fever and ill appearance
Preseptal cellulitis	Infection of lid tissues around the orbit, often with local skin defect	Red, swollen, tender eyelid; full extraocular movements; no vision changes
Mass effect from the orbit
Autoimmune orbital mass effect	Edema and inflammation of ocular muscles	Subacute onset bilateral proptosis, possible limited extraocular movements
Cavernous sinus thrombosis	Thrombosed superior ophthalmic vein and cerebral veins	Headache, vomiting, vision changes, stupor
Endophthalmitis	Inflammation of the globe, often caused by penetrating trauma	Vision loss
Orbital neoplasm	Tumor effect causing proptosis and affecting ocular muscle function and nerve function	Subacute onset, unilateral, painless proptosis