eye lumps

Question 1

Meibomian cyst (chalazion)
Is more commonly found on the upper eyelid.
Is usually 2–8 mm in diameter.
Is most commonly sited away from the lid margin.
Can affect one or both eyes (more than one meibomian cyst may be present).
May rupture through the skin.
There may be signs of minor conjunctival infection secondary to mechanical irritation or manipulation of the eye by the patient.

Answer 1

mangment
1-any red flags for malignancy , orbital cellulitis
2-usu resolve in 4 weeks
3-advise warm pads for 10 minutes then Gently massage the cyst afterThis should be done in the direction of the eyelashes using clean fingers or a cotton bud.
4-treat risk factors (sebrrohic dermatitis ,blepheritis ,rosacea)
5- if doesnt resolve in 4 weeks
A- refer to opthalomology (steriod injection -or surgery)
B- if small and a symptomatic you might not need to refer (discuss with patient )

Question 2

Styes (hordeola)
An acute-onset painful, localized swelling (papule or furuncle) near the eyelid margin that develops over several days.
1-external :Swelling is located at the eyelid margin (upper or lower).usually localized around an eyelash follicle.
A small, yellow, pus-filled spot may be visible.
Occasionally, multiple styes involve the entire eyelid.
2-internal :Swelling is tender and localized on the internal eyelid It is usually further away from the lid margin compared with an external stye.

DD
1-cyst of moll
2-cyst of zeis
3-Epidermal inclusion cyst

Answer 2

managment
1-exclude red flags for malignancy , cellulitis , alternatie diagnosis
2- conservative Apply a warm compress 5–10 minutes 2–4 times daily until the stye drains or resolves.
3-painful external stye A- pulcking the eye lash to Aid drainage
B-Incision and drainage of the stye using a fine sterile needle,(BY EXPERT)
4-abx Consider prescribing a topical antibiotic only if there are clinical features of spreading infection causing conjunctivitis
5-OPTHALOLOGY
A-The stye does not improve or resolve with management in primary care.
B- An internal stye is particularly large and painful.

Question 3

dacrocystitis

1-often caused by nasolacrimal obstruction
2-commonly associated with Staphylococcus aureus, Streptococcus pneumoniae, Pseudomonas species
clinical features

symotoms
pain, redness and swelling over the inner aspect of the lower eyelid and epiphora
digital pressure over the lacrimal sac may extrude pus through the punctum

Answer 3

treatment

acute
1-warm compresses, nasal decongestants
2-systemic and topic antibiotics

chronic,
1-obtain cultures by aspiration
2-dacryocystorhinostomy may be considered once the infection has resolved

Question 4

malignant eye tumers

1-basal cell carcinoma
(most common, about 80% to 95% of malignant eyelid tumours) — suggested by a nodule with a pearly edge and surface telangiectasia, and in some cases, central ulceration. Most commonly found on the medial canthus of the lower lid.

2-Squamous cell carcinoma
(about 5% to 10% of malignant eyelid tumours) — suggested by an ulcerating or hyperkeratotic lesion, most commonly on the lower lid.

Answer 4

3-eyelid melanoma