Eyelid Conditions Flashcards
List 7 Common Conditions of the Eyelid?
- Dermatochalasis
- Blepharitis
- Stye/chalazion
- Ectropion/entropion
- Trichiasis
- Tumourss: Benign vs. Malignant
- Dacryocystitis
Describe the Anatomy of the Eyelid?
What is this Eyelid condition?
= Dermatochalasis
Dermatochalasis is a term used to describe the presence of loose and redundant eyelid skin. It is a common sign of periocular aging and is often seen in middle-aged and elderly people. Although more dramatically seen in the upper eyelids, dermatochalasis can also affect lower eyelids as well.
What is this eyelid condition?
- 2 types?
- Clinical Features of each?
= Blepharitis
- Extremely common
- Chronic bilateral irritation and redness
- Associated with eczema, rosacea and psoriasis
Blepharitis (blepharitis squamosa)
- Definition?
- Aetiology?
- Classification?
Blepharitis
- Clinical Features?
What is the Treatment for Blepharitis?
Blepharitis - Treatment
- Lid scrubs (baby shampoo, bicarbonate of soda, Sterilid) * Warm compresses and massage
- Artificial tears (often associated with dry eyes).
- Omega-3 oils (fish, krill, flaxseed)
- Oral tetracycline eg. doxycycline 50mg od for 3 months
- Short course of topical steroids eg. Hycor 1% ointment
- Limited role for antibiotics
- Condition tends to flare-up if treatment is stopped: Important for patients to understand it is a chronic condition
What is this eyelid condition?
- Definition?
- Aetiology?
- Classification?
- Clinical features?
- Very common and often confused with a chalazion
- Can be difficult to distinguish clinically
- Often associated with blepharitis
- Infection of eyelash follicle
- Tender, red, ‘pointy’ lump with a small pus-filled center
Stye (External hordeolum)
- Treatment?
- Complications?
Stye (External hordeolum)
- Usually self-limiting
- Rx – Removal of eyelash, warm compresses, limited role for topical antibiotics, treat any underlying blepharitis.
What is this eyelid condition?
= Chalazion (Internal hordeolum, Meibomian cyst)
* Blocked meibomian gland
* Bigger, grows more slowly, less tender, rounded
Chalazion (Internal hordeolum, Meibomian cyst)
- Definition?
- Aetiology?
- Clinical Features?
Chalazion (Internal hordeolum, Meibomian cyst)
- Diagnostics?
- Treatment?
Chalazion
- Usually self-limiting
- Rx – Warm compresses, lid massage, limited role for topical antibiotics, incision & curettage if large or persistent, treat any underlying blepharitis.
- Persistent or recurrent chalazion may be a sign of a sebaceous carcinoma (a carcinoma of the meibomian gland).
- Chalazion may also clinically resemble a basal cell carcinoma!
What is this eyelid condition?
3 types?
Ectropion
- Abnormal eversion of the eyelid (usually lower) away from the globe
- Irritation, epiphora, exposure
- Involutional (most common), cicatricial, mechanical, paralytic (VIIn)
Ectropion
- Definition?
- Aetiology?
- Clinical Features? (5)
- Diagnostics?
- 3 Complications?
Ectropion - Clinical features
1. Conjunctival hyperemia
2. Blurry vision
3. Photophobia
4. Lagophthalmos
5. Epiphora
Diagnostics
- Ectropion is mainly a clinical diagnosis.
- Routine eye examination
Ectropion
- Treatment?
- 3 Complications?
Ectropion - Treatment
- None if mild or asymptomatic
- Tape lids at night to avoid exposure
- Surgery
What is this eyelid condition?
- Definition?
- Aetiology?
Entropion
- Abnormal inversion of the lid (usually lower) toward the globe
- Chronic irritation, epiphora, corneal abrasions, ulceration, infection
- Involutional (most common), cicatricial
Entropion
- Clinical Features?
- Diagnostics?
Entropion
- Treatment?
- 3 Complications?
Entropion - Treatment
1. Lubrication and tape for temporary relief
2. Surgery
Entropion - Complications
1. Trichiasis
2. Amblyopia with possible vision loss
3. Conjunctival and corneal lesions (e.g., corneal thinning, scarring, ulcers)
What are these eyelid conditions?
- Clinical features/Complications?
- Treatments? (4)
Trichiasis
- An abnormal inward growth of eyelashes towards the eye, which can cause conjunctival hyperemia, epiphora, and photophobia.
- Common complications include corneal abrasions and ulcers due to irritation.
- Misdirected lashes
- Primary or secondary (blepharitis, entropion)
- Chronic irritation, ulceration, infection
Treatment
1. Lubrication
2. Epilation
3. Electrolysis
4. Cryotherapy
Label these benign tumours/lesions of the eyelid.
Benign Tumours of the Eyelid
- Very common
- Squamous papilloma (warts), seborrheic keratosis, skin tags, nevus, cyst of Moll (sweat gland cyst), cyst of Zeis (sebaceous cyst), xanthelasma
- Sometimes difficult to differentiate clinically from cancerous lesions
- Treatment: Biopsy if in doubt & Surgical excision
Label these malignant tumours of the eyelid.
- List 4 risk factors?
Malignant Tumours of the Eyelid
- Common
- Risk factors: 1. Age, 2. Fair skin, 3. UV exposure, 4. Xeroderma pigmentosa
- Often a history of skin cancers on face/head
- Slowly enlarging usually painless lump that may ulcerate or bleed
- Usually on lower lid (greatest UV exposure)
Basal cell carcinoma of the eyelid
- What percentage of lid malignancies?
- Locations?
- 2 types?
- Behaviour?
- Tx?
Squamous cell carcinoma of the eyelid
- What percentage of lid malignancies?
- Locations?
- 3 types?
- Behaviour?
- Tx?
Malignant melanoma of the eyelid
- What percentage of lid malignancies?
- 3 types?
- Survival rate?
- Tx?
Sebaceous cell carcinoma of the eyelid
- What percentage of lid malignancies?
- Origin?
- Location?
- May mimic which 2 conditions?
- Mortality?
- Tx?
What eyelid condition is this?
- Aetiology?
- Treatment?
= Dacryocystitis
- Acute or chronic infection resulting in inflammation of the lacrimal sac. S. aureus, Pneumococcus, and Pseudomonas are the most common pathogens.
