Eye lid disorders Flashcards
Periorbital cellulitis : Definition
Bacterial infection of the soft tissues surrounding the eye - especially eyelids and skin around the eye
Periorbital cellulitis : Risk factors
- Bacterial infection
* Secondary infectious spread from;
-Sinusitis, Impetigo, Conjunctivitis - Poor immune system
* Diabetes, HIV/AIDS
Periorbital cellulitis : Clinical features
- Swelling and redness around the eye +/- discharge
- +/- fever
Periorbital cellulitis : Management
- Antibiotics : IV/PO
* Urgent mx to prevent developing into orbital cellulitis
Orbital cellulitis : Definition
Emergency : Bacterial infection involving tissue within the eye socket (Orbit)
Orbital cellulitis : Clinical features
Rapid onset development of symptoms
1. Swelling and redness
2. Eye movement : Restricted and severe pain
3. Proptosis : protrusion of eyeball
4. Vision impairment
5. Systemic sx : Fever, malaise
Orbital cellulitis : Complications
- Nerve compression
- Abscess formation
- Spread of infection - Cavern sinus thrombosis or Intracranial spread
Orbital cellulitis : Investigations
- CT / MRI scan
- Blood cultures
Orbital cellulitis : Management
- IV Antibiotics
- Surgical drainage of abscess
Belpharitis : Definition
- Chronic inflammation of the eye lid - at the base of the eyelashes
- Involves base of eyelid where eyelashes grow and adjacent oil glands which supply the oil onto the surface of the eye
Blepharitis : Causes
- Bacterial infection
-
Oil gland dysfunction : blockage can lead to inadequate lipid layer which increases evaporation of tears and dryness
* Seborrheic Dermatitis : excess oil production and inflammation
Blepharitis : Clinical features
- Redness + Swelling of eye-lid margins
- Gritty, itchy sensation in eyes
- Excessive dryness
Blepharitis : Management
Conservative mx
* warm compresses and gentle cleaning of the eyelid margins to remove debris
Stye : Definition
Staphylococcus aureus Infection of the sweat glands (Glands of Moll) at the base of the eyelashes
Stye : Clinical features
- Tender, red lump - contain pus
- Occurs at base of eyelash or inside eyelid
Stye : Management
- Conservative mx :
* Hot compresses and analgesia. - Topical antibiotics (e.g., chloramphenicol) : considered if it is associated with conjunctivitis
Chalazion : Definition
- Painless lump on the upper eye lid
- Caused by blockage of oil producing gland (meibomian) in the eyelid
Chalazion : Clinical features
- Upper eye lid - away from lash line
- Painless lump
- Gradual onset, and larger and firmer than a style
Chalazion : Management
Warm compresses to promote drainage.
Entropian : Definition
-
Eyelid turns inwards with the lashes pressed against the eye.
* Eyelash abrasion can cause corneal damage
Entropian : Causes
- Age : loss of elasticity in eyelid skin can contribute towards inwards turning of eye lid
- Muscle weakness : of eyelid muscles
Entropian : Clinical features
- Pain, irritation and redness
- Ulceration
Entropian : Management
- Tape down eyelid - prevent it from turning inwards
* Regular eyedrops
Ectropian : Definition
Eyelid turns outwards, exposing the inner aspect.
* Lower eyeball exposed - result in exposure keratopathy
Ectropian : Management
- Regular eyedrops
- Definitive mx : Surgery
Trichiasis : Definition
- Trichiasis refers to inward growth of the eyelashes.
- It results in pain and can cause corneal damage and ulceration.
- Requires removal of eyelashes
Conjunctivitis : Clinical presentation
Conjunctivitis presents with:
- Red, bloodshot eye
No pain or visual issues - Itchy or gritty sensation
- Discharge :
1. Bacterial conjunctivitis : Purulent discharge
2. Viral conjunctivitis : Clear discharge
-Assoc with sx of viral infection : dry cough, sore throat, blocked nose etc
Conjunctivitis : Management
- Hygiene measures : Very contagious, avoid contact
- Chloromphenicol eye drops : Bacterial infection
- Neontal conjunctivitis : Urgent referral as it may be 2nd to Gonoccal infection
