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Non-painful, acute-onset, unilateral eyelid edema due to wasp sting

A 47 year-old male presented with unilateral, non-painful, near-total, non-erythematous left eyelid swelling with anesthesia that developed overnight, approximately 24 hours after a wasp sting within the left eyebrow. The left eye itself remained unaffected. The acute findings completely resolved within four days of the event, mainly with supportive therapy. Hymenoptera venom can have marked neuromuscular effects on the superior eyelid, and clinicians are particularly alerted to the possibility of insect stings involving the supraorbital nerve within the differential diagnosis of non-painful, unilateral eyelid edema.

Author(s): Paul Varner