Brown recluse bite to the eyelid: a case report.

Brown recluse spider bites to the periorbital region have been reported rarely, particularly in pediatric patients. We report the case of a 17-year-old girl who developed periorbital and facial swelling after a brown recluse bite to the eyelid. Symptoms began within hours of the bite and progressed over the first 48 hours, leading to significant periorbital edema, chemosis, and elevated intraocular pressure (IOP). Symptoms improved 72 hours after the bite. Management included pressure-lowering eye drops, cool compresses, antihistamines, anti-inflammatories, and intravenous and oral antibiotics. IOP normalized without surgical intervention. Systemic symptoms did not occur, and swelling resolved over 2 weeks. This case highlights the potential for conservative management in cases without systemic toxicity or tissue necrosis and emphasizes the importance of monitoring for ocular complications in periorbital envenomation.