Eye: Eyelids Flashcards
1
Q
What is Nasolacrimal Duct Obstruction?
A
- Most common causes of persistent watery eye in an infant
- Caused by an imperforate membrane usually at lower end of lacrimal duct
2
Q
How is a nasolacrimal duct obstruction managed?
A
- Teach parents to massage the lacrimal duct
- Symptoms resolve in 95% by the age of one year.
- Unresolved cases should be referred to an ophthalmologist for consideration of probing, which is done under a light general anaesthetic
3
Q
What are the types of Squint?
A
Characterised by misalignment of visual axes
-
Concomitant (common)
- Due to imbalance in extraocular muscles. Convergent is more common than divergent
-
Paralytic (rare)
- Due to paralysis of extraocular muscles
4
Q
How is a squint detected?
A
Corneal light reflection test
- Holding a light source 30cm from the child’s face to see if the light reflects symmetrically on the pupils
5
Q
What is the use of the cover test?
A
Used to identify the nature of the squint
- Ask the child to focus on an object
- Cover one eye
- Observe movement of uncovered eye
- Cover other eye and repeat test
6
Q
How can squints be classified?
A
- The nose: esotropia
- Temporally: exotropia
- Superiorly: hypertropia
- Inferiorly: hypotropia
7
Q
How is a Squint managed?
A
Referral to secondary care
- eye patches may help prevent amblyopia (lazy eye)
8
Q
What is Endopthalmitis?
A
Typically red eye, pain and visual loss following intraocular surgery
9
Q
What is Blepharitis?
A
- Blepharitis is inflammation of the eyelid margins.
- It may due to either meibomian gland dysfunction (common, posterior blepharitis) or seborrhoeic dermatitis/staphylococcal infection (less common, anterior blepharitis).
- Blepharitis is also more common in patients with rosacea
10
Q
What is the effect of problems affecting the meibomian glands?
A
- The meibomian glands secrete oil on to the eye surface to prevent rapid evaporation of the tear film.
- Any problem affecting the meibomian glands (as in blepharitis) can hence cause drying of the eyes which in turns leads to irritation
11
Q
What are features of Blepharitis?
A
- Symptoms are usually bilateral
- Grittiness and discomfort, particularly around the eyelid margins
- Eyes may be sticky in the morning
- Eyelid margins may be red. Swollen eyelids may be seen in staphylococcal blepharitis
- Styes and chalazions are more common in patients with blepharitis
- Secondary conjunctivitis may occur
12
Q
What is the management for Blepharitis?
A
- Softening of the lid margin using hot compresses twice a day
- ‘Lid hygiene’ - mechanical removal of the debris from lid margins
- cotton wool buds dipped in a mixture of cooled boiled water and baby shampoo is often used
- an alternative is sodium bicarbonate, a teaspoonful in a cup of cooled water that has recently been boiled
- Artificial tears may be given for symptom relief in people with dry eyes or an abnormal tear film
13
Q
What are common eyelid problems?
A
- Blepharitis: inflammation of the eyelid margins typically leading to a red eye
- Stye: infection of the glands of the eyelids
- Chalazion (Meibomian cyst)
- Entropion: in-turning of the eyelids
- Ectropion: out-turning of the eyelids
14
Q
What are the different types of Stye?
A
- External (hordeolum externum): infection (usually staphylococcal) of the glands of Zeis (sebum producing) or glands of Moll (sweat glands).
- Internal (hordeolum internum): infection of the Meibomian glands. May leave a residual chalazion (Meibomian cyst)
15
Q
How is a Stye managed?
A
Management includes:
- Hot compresses
- Analgesia.
- CKS only recommend topical antibiotics if there is an associated conjunctivitis
