Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

KMK Ocular Disease > 4 - Lids/Lashes/Lacrimal > Flashcards

4 - Lids/Lashes/Lacrimal Flashcards

1
Q

Dermatochalasis

A

Elderly

Weak orbital septum -> redundant upper lid skin -> ptosis, pseudoptosis, loss of distinct lid creases, superior VFD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Blepharitis

  • ant vs post
  • symptoms
  • staph vs seb
A

Gray line (most ant Riolan) divides, posterior = meibomitis

Often asymptomatic; vision that clears after blinking, burn/itch/fbs, tearing, CRUSTING IN THE MORNING, mild discharge

Seborrh: oily/greasy/flaky, less inflammation, more madarosis and/or misdirected growth
-assoc with seb dermatitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Chalazion

  • history
  • pathophys
  • signs/symp
A

Often have hx of similar recurrent lesions - ask about ACNE ROSACEA and seborrheic dermatitis
-evaluate for sebaceous gland carcinoma

Chronic, localized, STERILE INFLAMMATION of meibomian gland

  • due to retention of normal secretions
  • 25% resolve spontaneously

HARD, PAINLESS, IMMOBILE nodule without redness
Usually upper lid, asymptomatic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Hordeolum

  • history
  • pathophys
  • signs/symp
A

Often have hx of similar recurrent lesions - ask about ACNE ROSACEA and seborrheic dermatitis
-can lead to preseptal

Acute STAPH INFECTION of glands

  • internal = meibomian
  • external = moll/zeis (aka stye)

TENDER, RED, WARM are of focal swelling

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Glands affected: chalazion vs hordeolum

A

chalazi”ON” = “meibomiON”

Hordeola:

  • internal = meibomian
  • external = moll/zeis (stye)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Lid cysts

  • inclusion
  • milia
  • dermoid
  • sebaceous
A

I: KERATIN, congenital or acquired, white

M: SWEAT PORE occlusion, acquired, white

D: SUP-TEMP, congenital, firm + immobile

S: YELLOW/OPAQUE, solitary, smooth, retention of fluid in glands of zeis or retention of debris in meibomian

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Ectropion

  • pathophys
  • signs/symp
A

Eversion of lid away from globe
#1: involutional (loss of musc tone of orb.oculi)
-also cicatricial, paralytic (bell’s), congenital

Exposure keratopathy, epiphora, brow ptosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Entropion

  • pathophys
  • signs/symp
A

Inversion of lid against globe
#1: involutional
-also cicatricial (trachoma, OCP, SJS, etc.), congenital
Can result in pseudotrichiasis

Range of symp: mild punctate keratitis -> corneal ulceration* and pannus
*blindness from trachoma due to corneal ulceration secondary to entropion and trichiasis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Trichiasis vs distichiasis

A

T: lashes grow posteriorly

D: second row of lashes from MG openings

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Floppy eyelid syndrome

  • who
  • pathophys
A

Obese men with obstructive sleep apnea, esp face-down sleepers
-also DM, HTN, hyperthyroidism

Significant reduction in elastin in TP -> spontaneous lid eversion

  • due to mechanical trauma to TP
  • leads to PAPILLARY CONJ-ITIS due to FRICTION (non-specific pabillae)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Floppy eyelid syndrome

-signs/symp

A

Signs: chronic PAPILLARY CONJ-ITIS, loose upper lids, punctate epithelial keratopathy (50%), keratoconus

Symp: chronic, bilateral red eyes in morning upon wakening
-often with mild mucus discharge

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Ocular problems assoc with sleep apnea (3)

A

Floppy eyelid
NTG
NAION

(Low oxygen)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Ocular condns that most often cause red eyes in the morning (3)

A

Floppy eyelid
RCE
Exposure k

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Benign essential blepharospasm

  • who
  • pathophys
A

Women (2:1), 50-70yo

Usually IDIOPATHIC

  • corneal or conj irritation
  • initially have random episodes -> progresses to involuntary spasms
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Benign essential blepharospasm

  • signs/symp
  • systemic condn
A

Signs: spasms of 1) orb.oculi 2) procerus 3) corrugator
-50% have an ocular surface disorder (esp dry eye)

Symp: involuntary, sustained, repetitive, BILATERAL twitching/forceful closure, less common during sleep

Meige = BEB + lower facial abnormalities (difficulty chewing, jaw spasms, jaw pain, etc.)
-50% of pts with BEB have Meige

*tx with botox

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Myokymia

A

Unilateral twitching of orb.oculi

Causes: sleep deprivation, too much caffeine, stress
-much more common than BEB

17
Q

Basal cell carcinoma

-who

A

Most common skin + eyelid cancer (90% of lid malignancies)
Males (2:1)
Fair skin, UV exposure (esp B (290-320))

Pts often report chronic lesion that occasionally bleeds and won’t heal

18
Q

Basal cell carcinoma

  • pathophys
  • signs
A

Malignancy of basal cell layer of epidermis
Minimally invasive (metastasis <0.1%)
Most commonly on LL (50-66%) and at medial canthus

Early: SHINY, FIRM, PEARLY nodule with superficial TELANGIECTASIA
Late: RODENT ULCER

19
Q

Squamous cell carcinoma

-who

A

2nd most common eyelid cancer (40-50x less than BCC)
Males (2:1)
Fair skin, UV exposure (esp B (290-320))

20
Q

Squamous cell carcinoma

-pathophys

A

Malignancy of stratus spinosum layer of epidermis
More aggressive than BCC: 13-24% undergo metastasis to nearby lymph nodes

Actinic keratosis: most common precancerous skin lesion, precursor to SCC (25% develop into SCC)
-elevated, pink/red, scaly lesion on sun-exposed skin

21
Q

Squamous cell carcinoma

-signs

A

Variable presentation
Similar to BCC but without telangiectasia
Typically lower lid or lid margin

22
Q

Keratoacanthoma

A

Sun-exposed areas
Early app: similar to BCC/SCC
Grow very quickly to large size (1-2cm) before slowly shrinking/spontaneously resolving

23
Q

Sebaceous gland carcinoma

-who

A

Rare
Elderly females
Hx of chronic unilateral blepharitis or recurrent chalazia

24
Q

Sebaceous gland carcinoma

-pathophys

A

Neoplasm of 1)meibomian 2)zeis (holocrine)
Poor prognosis: if >2cm mortailty rate is 60%
-symptoms present >6mo mortality rate is 38%
-overall mortality rate 10%

25
Q

Sebaceous gland carcinoma

-signs

A

Varies

Often HARD AND YELLOW, assoc with MADAROSIS, thickened/red lid margins

26
Q

Malignant melanoma

  • who
  • pathophys
A

Rare (<1% lid malignancies), most lethal
-age, skin color, fam hx, repeated irritation, sun exposure

Malignancy of melanoCYTES

27
Q

Malignant melanoma

-signs

A 
A: asymmetry
B: border irreg
C: color differences/uneven pigment
D: diameter
E: enlargment

Most important prognostic is depth of invasion

28
Q

Dacryadenitis

  • who
  • pathophys: acute vs chronic
  • causes (kind of reiterating from pathophys…)
A

Children, possible hx of recent fever/systemic infection

Inflammation of lacrimal land
Acute: bacterial (esp STAPH AUREUS), viral (esp MONO)
Chronic: MORE COMMON, from inflammatory disorders - SARCOID, tuberculosis, graves, idiopathic orbital inflammation

Causes: 
#1 NLDO (adult = involutional, kid = hasner)
#2 maxillary sinus
29
Q

Dacryadenitis

-signs/symp: acute vs chronic

A

Acute: S-SHAPED PTOSIS, temporal upper lid pain, redness, swelling, PREAURICULAR LYMPHADENOPATHY, fever, elev WBCs

Chronic: temporal upper lid swelling, less of everything else than acute
-may lead to inferonasal globe displacement, proptosis

30
Q

Canaliculitis

-pathophys

A

Rare
Inflammation of canaliculi
Bacterial, viral, or fungal
-usually ACTINOMYCES ISRAELII (streptothrix): YELLOW SULFUR GRANULES after expression of canaliculi
-others: staph aureus, candida albicans, aspergillus, herpes s/z, nocardia asteroides

31
Q

Canaliculitis

-signs/symp

A

Signs: tenderness over nasal lids, swollen “POUTING” puncta, dacryoliths, mucopurulent discharge

Symp: smoldering, unilateral red eye, often unresponsive to antibiotic tx, often misdx as recurrent conj-itis

*tx pcn

32
Q

Dacryocystitis

  • history
  • pathophys
  • causes (kind of reiterating from pathophys…)
A

Ask about concomitant ENT infection

Lac sac infection due to NLDO -> backflow of bacteria from NLD into sac
-common causes: STAPH AUREUS/epidermidis, pseudomonas, H FLU in children
Chronic cases should raise suspicion for epithelial carcinomas, malignant lymphomas

Causes: 
#1 NLDO (adult = involutional, kid = hasner)
#2 maxillary sinus
33
Q

Dacryocystitis

-signs/symps

A

Signs: prominent edema + tenderness over sac

  • swelling below medial canthus tendons
  • swelling above should raise suspicion for lac sac tumor

Symp: PAIN, often with crusting/tearing, occassional fever

*cystitis has more swelling, tenderness, pain than canaliculitis

34
Q

Punctal stenosis

A

Narrowing/occlusion of puncta - no concensus on clinical definition
Usually involutional
Epiphora

35
Q

Nasolacrimal duct obstruction

  • who
  • pathophys
  • signs/symp
A

Congenital or acquired - acquired more common in females

Older pts: involutional stenosis
Younger: valve of Hasner blocked by membrane
-spontaneous opening around 1-2mo

Signs: epiphora, mucus, erythema, little tenderness/redness

Symp: unil tearing, discharge, crusting, recurring conj-itis

36
Q

Jones testing

A

1: fluoroscein, five minutes
- positive = patent -> confirmed by presence of fluoro in back of throat or having them blow their nose
- if negative, go to Jones 2

2: irrigation with saline
- want: taste saline, gag, fluid recovery from nose
- if failed, DCR is next step

KMK Ocular Disease (17 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions