A 68-year-old man presented to an outside emergency department with 2 days of progressive bilateral eyelid swelling.
He had a history of stage IVa transglottic laryngeal squamous cell carcinoma status post laryngectomy, bilateral neck dissection, and adjuvant chemoradiation currently on pembrolizumab complicated by immune checkpoint inhibitor-associated truncal and facial rash on prednisone.
His ocular history was notable for cataract extraction with IOL implantation in both eyes several years prior. His social history included a 20-pack-year cigarette smoking history.
On presentation, the