Eyelid disorders Flashcards
Eye lid disorders
Blepharitis Syle Chalazion Entropion Ectropion Trichiasis Periorbital cellulitis Orbital cellulitis
Blepharitis
Inflammation of the eyelid margins
Presentation of blepharitis
Gritty, itchy, dry sensation in the eyes
What is blepharitis associated with
Dysfunctional meibomian glands
Management of blepharitis
Hot compresses
Gentle cleaning of the eyelid margins - remove debris using cotton wool dipped in sterilised water and baby shampoo
Lubricating eye drops
Lubricating eye drops
Hypromellose - least viscous, lasts around 10 minutes
Polyvinyl alcohol - middle viscous, worth starting with these
Carbomer - most viscous and lasts 30 – 60 minutes
Stye
Hordeolum externum - an infection of the glands of Zeis or glands of Moll
Causes a tender red lump along the eyelid that may contain pus
Hordeolum internum
Infection of the Meibomian glands
Treatment of styes
Hot compresses and analgesia
When to consider topical abx for styes
If associated with conjunctivitis or persistent
Chalazion pathophysiology
When a Meibomian gland becomes blocked and swells up
Swelling in the lower eyelid that is typically not tender but can be tender and red
Treatment of chalazion
Hot compress and analgesia
When to consider topical abx for chalazions
If acutely inflamed
If conservative management fails to resolve a chalazion
Surgical drainage
How long can chalazions last for
3 -6 months
Entropion
Eyelid turns inwards with the lashes against the eyeball
Presentation of entropion
Pain
Can result in corneal damage and ulceration
Management of entropion
Initial management - taping the eyelid down to prevent it turning inwards
Definitive management - surgical intervention.
When the eyelid is taped down, use lubricating eyed drops to prevent the eye drying out
A same-day referral to ophthalmology is required if there is a risk to sight.
Ectropion
Ectropion is where the eyelid turns outwards with the inner aspect of the eyelid exposed. It usually affects the bottom lid
Complication of ectropion
Exposure keratopathy
Management of ectropion
Regular lubricating eye drops
More significant cases - surgery to correct the defect
A same-day referral to ophthalmology is required if there is a risk to sight.
Trichiasis
Inward growth of the eyelashes
Presentation of trichiasis
Pain and can cause corneal damage or ulceration
Management of trichiasis
Specialist - remove the eyelash (epilation).
Recurrent cases may require electrolysis, cryotherapy or laser treatment to prevent the lash regrowing.
A same day referral to ophthalmology is required if there is a risk to sight.
