Disorders of the Eyelids and Lacrimal Apparatus

Question 1

Hordeolum vs Chalazion

Answer 1

Hordeolum - usually caused by infection and remains painful and localizes to eyelid margin

Chalazion - caused by non-infectious meibomian gland, becomes small nontender nodule in eyelid corner

Question 2

Both are sudden onset localized swellings of eyelid
both initially cause eyelid hyperemia, edema, swelling and pain

Answer 2

Hordeolum and Chalazion

Question 3

Treatment of Hordeolum and Chalazion

Answer 3

Primarily hot compresses
Both conditions improve spontaneously
via ophtho consult - corticosteroid injection (chalazion), oral abx (hordeola)

Question 4

Chalazion sx

Answer 4

initially diffuse swollen eye
1-2 days localizes to body of eyelid
small non-tender nodule or lump develops
spontaneously absorbed over 2-8 wks
depending on size and location can cause slightly blurred vision

Question 5

Hordeolum (stye) sx

Answer 5

acute localized swelling of eyelid that may be external or internal
usually staph
result from obstruction and infection of eyelash follicle and adjacent glands
external - 2-4 days lesion ruptures and discharges material thereby relieving pain, resolving lesion
internal - rupture is rare, recurrence is common

Question 6

inflammation of the eyelid margins, acute or chronic

Answer 6

Blepharitis

Question 7

Two types of blepharitis

Answer 7

acute ulcerative
acute non-ulcerative

Question 8

itching and burning of eyelid margins with redness and edema
conjunctival irritation with lacrimation, photosensitivity, FB sensation

Answer 8

Blepharitis s/sx

Question 9

treatment of acute ulcerative and non-ulcerative blepharitis

Answer 9

ulcerative - topical abx or systemic antiviral
non-ulcerative - topical corticosteroids

Question 10

Chronic blepharitis treatment

Answer 10

tear supplements
warm compresses
oral abx - maybe

Question 11

usually bacterial infection (staph) of eyelid margin at origins of eyelashes; last follicles and meibomian glands
can have viral source (HSV, VZV)

Answer 11

acute blepharitis

Question 12

acute non-ulcerative blepharitis is usually caused by

Answer 12

allergic reaction involving the same area (intense itching, rubbing, rash)

Question 13

entropion vs ectropion

Answer 13

entropion is inversion of an eyelid
ectropion is eversion of lower eyelid

Question 14

Entropion is caused by

Answer 14

age-related tissue relaxation, post infectious changes, post traumatic changes or blepharospasm

Question 15

Entropion treatment

Answer 15

surgery

Question 16

Ectropion is caused by

Answer 16

age-related tissue relaxation, CN 7 palsy, posttraumatic or postsurgical changes

Question 17

Ectropion treatment

Answer 17

surgery

Question 18

Dacryocystitis is

Answer 18

an infection of lacrimal sac that may lead to abscess formation, usually caused by staph or strep
consequence of nasolacrimal duct obstruction

Question 19

Acute Dacryocystitis presents with

Answer 19

pain, redness, edema, around lacrimal sac

Question 20

Acute Dacryocystitis treatment

Answer 20

warm compresses, oral abx
severe - IV abx
if not responsive - consider MRSA and change abx
abscess may be drained, abx change based on cx results

Question 21

Chronic Dacryocystitis presents with

Answer 21

Present with mass under medial canthal tendon and chronic conjunctivitis

Question 22

Treatment of chronic dacryocystitis

Answer 22

usually surgery, create passage between lacrimal sac and nasal cavity (dacryocystorhinostomy)

Question 23

Premalignant/ Malignant Eyelid tumors consist of

Answer 23

actinic keratosis
xeroderma pigmentosum
basal cell carcinoma
squamous cell carcinoma

Question 24

Xanthelasma is

Answer 24

common benign deposit of yellow-white flat plaques of lipid material subcutaneously on upper and lower eyelids

Question 25

Xanthelasma treatment

Answer 25

no treatment needed; may be removed for cosmetic reasons underlying dyslipidemias should be properly managed

Question 26

Melanocytic eyelid tumors benign

Answer 26

freckles
lentigo simplex
solar lentigo
eyelid nevi: congenital or acquired