Allergic Eyelid Dermatitis as the Sole Manifestation of Gold Hypersensitivity

Gold hypersensitivity is a cause of periorbital dermatitis that often presents as a diagnostic challenge for many ophthalmologists. Six female patients are described as presenting with isolated bilateral periorbital dermatitis. Main symptoms included itching (3/6), eyelid redness (3/6), and drooping eyelids (3/6) for an average duration of 16.8 months prior to referral. All 6 patients failed conservative management. Recurrence of symptoms necessitated allergic patch testing, revealing a severe hypersensitivity reaction to gold in all cases. By discontinuing contact with gold, specifically gold jewelry, the allergic periorbital dermatitis completely resolved. No patients required surgical intervention for eyelid malposition. Increased awareness of this reversible cause of allergic periorbital dermatitis may improve patient outcomes.