Eye Care - Eyelid Conditions Flashcards
Acute infection of 1 or more eyelid glands (meibomian, Zeis or Moll)?
stye
Sterile, focal, chronic inflammation of the lid due to obstructed meibomian gland?
Chalazion
Chronic inflammation of the lid margins associated with infection, dermatological conditions or meibomian gland dysfunction?
Blepharitis
what are symptoms of style?
Unilateral painful lesion, localized lid swelling, tenderness, erythema
what are symptoms of chalazion?
Non-tender (painless), rubbery nodule, localized lid swelling, often unilateral
what are symptoms of blepharitis?
Irritated, possibly reddened lid margins; greasy, scaly and/or flaky; usually bilateral
when is the onset of stye, chalazion, and blepharitis?
stye - acute (days);
chalazion - gradual enlargement (days to weeks);
blepharitis - gradual irritation (weeks to months)
what is the most common causing organism for stye?
Staph aureus
what is the difference between internal and external stye?
When the glands of Zeis or Moll are involved, the infection is smaller, more superficial and referred to as an external stye;
An internal stye is marked by a larger area of swelling that usually involves the meibomian glands; the lesion can point either to the skin or to the conjunctival surface.
As compared with the external stye, the internal stye generally has a more prolonged course.
non pharm measure for external stye?
External styes usually drain spontaneously within 48 hours;
warm compresses applied for 10–15 minutes 3 or 4 times a day may hasten resolution - Following the application of warm compresses, gently massaging the eyelid toward the lid margin;
non pharm measure for internal stye?
generally resolve spontaneously within 1–2 weeks;
Warm compresses applied for 10–15 minutes 3 or 4 times a day can be used, although there are no clinical trials that demonstrate effectiveness of non-surgical interventions, including compresses, for acute internal styes.[16]
Patients should seek medical advice if they have internal styes that do not resolve in 1 week
pharm treatment for stye?
Self-medication with nonprescription ophthalmic antibacterials is not necessary and is not recommended, since the majority of styes drain spontaneously;
If incision and drainage are required, an ophthalmic antibacterial ointment such as erythromycin, applied to the conjunctival sac several times a day, is common practice to prevent further infection
nonpharm measure for chalazion?
Warm compresses, applied several times a day, are used to soften sebaceous secretions that may be blocking meibomian gland orifices. Approximately 25–50% of lesions resolve with this treatment. Following the application of warm compresses, gentle massage of the eyelid toward the lid margin may also be helpful.
pharm measure for chalazia?
Since chalazia are not the result of an infectious process, self-medication with nonprescription ophthalmic antibacterials is not recommended;
Larger chalazia may require surgical excision, intralesional steroid injections or both;
Topical antibacterials or corticosteroid drops may be prescribed after surgery to prevent infection and decrease inflammation. The presence of cellulitis is an indication for the use of systemic antibacterials.
which parasite infestations may also contribute to blepharitis?
Demodex mites;
Phthirus pubis (crab lice) - less common
how to classify blepharitis?
anterior - staphylococcal or seborrheic;
posterior - Meibomian gland dysfunction
how to prevent blepharitis?
Encourage patients to maintain a long-term lid hygiene program, as this helps prevent exacerbations and long-term complications. Treatment of dermatologic disorders elsewhere in the body, such as seborrheic dermatitis, is important in achieving long-term control of blepharitis
nonpharm treatment for blepharitis?
Treatment for all types of blepharitis consists of regular and long-term eyelid margin hygiene:[8][30][31][33]
- Warm compresses, applied to closed eyelids for 5–10 minutes, help to melt solidified material in the glands. There are commercially available products (e.g., Eyegiene) that maintain a temperature of 43°C for 10 minutes to provide optimal softening of meibomian gland secretions.
- Gentle cleansing of the lid margin: instruct the patient to gently scrub only the lid margin, not the conjunctiva or outer lid area, using either warm water with a facecloth, a cotton swab/facecloth dipped in a solution of baby shampoo diluted with warm water, or commercial eyelid wipes.
- The patient may be instructed to perform firm massage of the lid margins after applying warm compresses to enhance secretion from the meibomian glands. One hand holds the eyelid taut at the outer corner, while the index finger of the other hand presses along the lid from the inner corner out. Alternatively, the patient may simply apply direct pressure to the lid if that is more comfortable. Mechanical expression performed by an ophthalmologist may be necessary to decrease the amount of irritating lipids within the glands.
- Artificial tears may help to alleviate symptoms, especially in patients with associated dry eye disease. For more information, see Dry Eye.
If blepharitis persists despite adherence to eyelid margin hygiene, consider assessing whether the patient used a lid hygiene product containing which ingredient?
cocamidopropyl betaine (CAPB) - CAPB is a surfactant present in many cosmetic and self-care products, including baby shampoo and eyelid scrub products, that is known to cause contact dermatitis and eyelid dermatitis
what are pharm treatment for blepharitis?
antibacterials - erythromycin;
eye anti-inflam agents - eye steroid or steroid/AB combo;
other agents - immunomodulatory - cyclosporine 0.05% eye drop, oral ivermectin for demodex infestation and/or ocular rosacea ;
natural health products - omega-3 & tea tree oil lid cleansers or shampoo (Demodex)
