eyelid/conjunctival disorders 1

Question 1

what are the disorders of the eyelashes?

Answer 1

. trichiasis

Question 2

what are the anomalies of lid position?

Answer 2

. ptosis
. entropion - margin of eyelid turns inwards
. ectropion - margin of eyelid turns outwards

Question 3

what are benign lid lesions?

Answer 3

. hordeolum-
. chalazion
.cysts of moll and zeis
. molluscum contagiosum

Question 4

what is internal hordeolum?

Answer 4

. infection of meibomian gland

Question 5

what is external hordeolum ?

Answer 5

. infection of glands associated with eyelashes

. referred to as stye

Question 6

what is chalazion?

Answer 6

. inflammatory response in the meimbomian gland

Question 7

what are malignant eyelid lesions ?

Answer 7

. basal cell carcinoma

. squamous cell carcinoma

Question 8

what is blepharitis?

Answer 8

swollen itchy eyelid

Question 9

what is trichiasis?

Answer 9

. disorder of eyelashes
. common lid abnormality
. misdirection of eyelashes towards the globe
. most common in the elderly
e.g entropion - when the eyelid turns inwards so does the eyelashes
. causes foreign body sensation, epiphora ( watering ) associated with a red eye
. treatment includes: lubricants/bandage contact lens, epilation ( regrown in 4-6 weeks ) or electrolysis/cryotherapy

Question 10

what is ptosis ?

Answer 10

. anomaly of lid position
1- aetiology
. congenital - rare
. acquired ( age, trauma, neurological, myogenic)

2- investigation
. assess underlying cause
. assessment of levator function

3- treatment
. levator advancement or resection, frontalis sling ( brow suspension)

Question 11

what is the most common cause of ptosis?

Answer 11

. neurological cause
. where the 3rd cranial nerve , the ocular motor nerve which innervates the levator palpebrae superioris which is the eyelid innovator and ensures palpebrae aperture is open
. works with superior tarsal muscle which is an accessory eyelid innovator

Question 12

what are the signs of horner’s syndrome ?

Answer 12

. ptosis
. myosis - constriction of pupil
. anhidrosis - absence of sweating on the affected side

Question 13

what is entropion ?

Answer 13

. inversion of the eyelid margin (usually lower )
1. aetiology: congenital, involutional-age (senile ) or cicatricial ( scarring )

2. symptoms: foreign body sensation, epiphora
3. signs: conjunctival hyperaema, may also show corneal damage
4. treatment: surgery

Question 14

what is ectropion?

Answer 14

. eversion of the eyelid away from the globe

1. aetiology
. involutional ( senile)
. paralytic ( VII palsy )
. cicatricial - trauma/ scarring
. congenital 

2. symptoms:
   .causes irritation and epiphora
   . may be corneal involvement
3. treatment: surgery

Question 15

what is hordeolum ?

Answer 15

. external stye
. internal ( acute infection of meibomian glands)
. chronic blepharitis may be a predisposing factor
. presents as tender swelling of eyelid with local hyperamia
. treatment : topical or oral antibiotics, warm compresses

Question 16

what is chalazion?

Answer 16

. type of acute hordeolum
. infection of meimbomian gland
. internal hordeolum
. blockage of meibomian gland duct with retention of secretion
. may be secondary to blepharitis
. presents as painless lid lump ( may be multiple and recurrent )
. usually resolve spontaneously ( warm compresses may spreed resolution)OR INCISION to scoop this lesion out- minor surgery.

Question 17

what are some other benign eyelid lesions?

Answer 17

1. molluscum contagiosum
2. cyst of zeis
3. cysts of moll

Question 18

what is molluscum contagiosum?

Answer 18

. caused by virus
. eyes are red
. causes follicular conjunctivitis

Question 19

what is cyst of zeis and cysts of moll?

Answer 19

. cysts of ciliary glands associated with eyelash follicles

Question 20

what are cysts of zeis?

Answer 20

. blocked sebaceous glands

Question 21

what are cysts of moll?

Answer 21

. sweat glands

. watery

Question 22

what are the malignant lesions of the eyelid?

Answer 22

. basal cell carcinoma

. squamous cell carcinoma

Question 23

what are basal cell carcinoma?

Answer 23

. can occur anywhere in the body
. tend to occur in exposed area
. can affect lacrimal drainage system

Question 24

what are squamous cell carcinoma?

Answer 24

. form of cancer

Question 25

explain the difference between pre-septal and orbital cellulitis?

Answer 25

. pre-septal cellulitis have normal ocular motility, visual acuity and RAPD
. in pre-septal , proptosis is absent

. in orbital cellulitis, proptosis is present
. in orbital cellulitis, ocular motility is painful
. in orbital cellulitis, visual acuity is reduced
. in orbital cellulitis , RAPD is present

. always assume it’s orbital cellulitis

Question 26

what is blepharitis ?

Answer 26

. lid margin disease
. anterior, posterior, mixed
. associated with dry eye
. inflammatory response to bacteria

1. symptoms
   - ocular discomfort ( burning, stinging )
   - blurring
2. signs
   - lid margin hyperamia
   - crusting of lashes
   - plugging of duct orifices
   - unstable tear film
3. treatment
   . lid hygiene
   . warm compresses to make meibomian gland secretion flowing, to un block
   . topical/oral antibiotics