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HEENT > Blepharitis and Disorders of the eyelid > Flashcards

Blepharitis and Disorders of the eyelid Flashcards

1
Q

this structure secretes sebum and contributes to the outermost oily layer of the tear film

A

Meibomian glands

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2
Q

modified sweat glands that either open between two eyelashes or into a gland of Zeis

A

glands of moll

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3
Q

modified sebaceous glands that are attached directly to eyelash follicles

A

glands of zeis

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4
Q

Chronic eyelid condition: bilateral presentation with conjunctival redness and inflammation around the eyelid margins

A

Blepharitis

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5
Q

What causes blepharitis?

A

underlying medical conditions (rosacea, dermatitis, dry eye)
bacterial infections (S. aureus, s. epidermidis)
parasitic infestations (demodex spp, mites)
other ( cig smoking, contact lenses)

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6
Q

What are the two components of blepharitis?

A
  1. Anterior blepharitis

2. Posterior blepharitis

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7
Q

What location is the anterior margin of the eyelid?

A

outer portion of the eyelid

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8
Q

What is anterior blepharitis and is it less or more common than posterior blepharitis?

A

inflammation along the eyelashes

less common than posterior blepharitis

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9
Q

What are the two types of anterior blepharitis?

A
  1. staphylococcal-type

2. seborrheic type

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10
Q

What causes staphylococcal type blepharitis?

A

S. aureus, and S. epidermidis organisms

  1. through direct infection of the eyelids
  2. exotoxin
  3. allergic response
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11
Q

Signs and symptoms of staphylococcal-type blepharitis

A

inflammation and redness around the anterior of the eyelids
HARD and CRUSTY SCALES on the eyelash
conjunctival redness

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12
Q

What causes seborrheic-type blepharitis

A

occurs in ppl with seborrheic dermatitis

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13
Q

Signs and symptoms of seborrheic type blepharitis

A

inflammation and redness around the anterior margin of the eyelids
OILY and GREASY SCALES around the eyelashes
conjunctival redness

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14
Q

What type of blepharitis affects the inner portion of the eyelid?

A

posterior blepharitis

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15
Q

What causes posterior blepharitis?

A

meibomian gland dysfunction

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16
Q

What are the 2 types of meibomian gland dysfunction?

A
  1. meibomian seborrhea
  2. meibomianitis

composition of tear film is changed or blockage of meibomian ducts

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17
Q

Signs and symptoms of meibomian seborrhea

A

little to no inflammation of the posterior lid margin
conjunctival redness
SENSITIVITY TO LIGHT, BURNING SENSATION
OILY, FOAMY, FROTHY, TEAR FILM

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18
Q

signs and symptoms of meibomianitis

A

inflammation of the posterior lid margin
partial or complete obstruction of the meibomian glands;
applying pressure = THICK, WAXY SECRETION released

19
Q

Main tip of non-pharm therapy?

A

good eyelid hygiene for all types

20
Q

What treatment for mild to moderate symptoms?

A

non-pharm therapy alone

21
Q

what treatment for severe symptoms or recurrent blepharitis?

A

non-pharm AND pharmacological therapy together

22
Q

List 3 non-pharm measures to treat blepharitis

A
  1. Warm compress and eyelid massage
    - circular motion
    - heat softens secretions and massage = clear blockages
  2. Eyelid Washing
    - dilute baby shampoo, eyelid cleaner, light tough
    - removes buildup and debris
  3. Artificial Tears
    - symptomatic relief
    - dry eye or for ppl that smoke or use contact lenses
23
Q

Why are ointments preferred instead of drops for the treatment of anterior blepharitis?

A

easier to use

leads to increased contact time

24
Q

Pharmacological treatment for anterior blepharitis?

A
  1. erythromycin 0.5% qhs 1 x week

2. Fucithalmic 1% viscous drops 1 gtt q12h x 1 week (viscous = longer contact time)

25
Q

Pharmacological treatment for posterior blepharitis

A
  1. doxycycline 100 mg po daily
  2. minocycline 50-100 mg po daily
  3. tetracycline 250 mg po qid
  4. erythromycin 250 mg po qid
  5. azithromycin 1000 mg po weekly or 500 mg po daily x 3 days per week
26
Q

How long is the pharmacological treatment for posterior blepharitis?

A

2-4 weeks depending on symptoms

27
Q

what is the formal name for a stye?

A

hordeolum

28
Q

What causes hordeolum (stye)

A

bacterial infection

S. aureus

29
Q

What are the two types of hordeolum?

A
  1. external hordeolum

2. internal hordeolum

30
Q

this type of stye typically involves the glands of moll and/or Zeis and tend to be smaller in size

A

External hordeolum

31
Q

this type of style involves the meibomian gland and tend to be larger in size with more pronounced swelling

A

internal hordeolum

32
Q

What are contributing factors to stye

A

underlying medical conditions

other (eye makeup )

33
Q

Signs and symptoms for a stye?

A

single PAINFUL lesion
unilateral
LOCALIZED REDNESS and INFLAMMATION
ACUTE ONSET

34
Q

lesion that occurs due to meibomian gland blockage?

A

chalazion

35
Q

T or F: chalazion lesion is sterile

A

TRUE

it points inwards and causes conjunctival irritation

36
Q

What can contribute to chalazion

A

underlying medical condition (blepharitis, rosacea, seborrheic dermatitis)

37
Q

Signs and symptoms of chalazion

A

single PAINLESS lesion
GRADUAL onset
unilateral, localized swelling

38
Q

Timeline of hordeolum and chalazion being resolved by
external hordeolum: ____
internal hordeolum: _____
chalazia: ____________ (depending on size)

A

external: 2 days
internal: 1 week
chalazia: several days to 1 week

39
Q

Non-pharm measures for the treatment of chalazia and styes

A
  1. warm compress and eyelid massage

2. Eyelid washing

40
Q

What do you do when a stye doesn’t resolve in that time frame?

A

refer to physician
they can surgically incise and drain the lesion + topical antibiotic AFTER the surgical incision
Erythromycin ung 05% qhs x7/7

41
Q

When are oral antibiotics used in the treatment of styes?

A

only when cellulitis is suspected

42
Q

T or F: antibiotics are indicated for chalaziion

A

no antibiotics are not indicated for chalazion because chalazion are sterile

43
Q

Topical antibiotics are used when dr incises the chalazion lesion and are used for after that. Erythromycin ointment

+ corticosteroid injection

A

HEENT (14 decks)

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