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Ophthalmology > Eyelid Disorders > Flashcards

Eyelid Disorders Flashcards

1
Q

What is blepharitis

A

Inflammatory condition of the eyelid margin

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2
Q

Risk factors for blepharitis

A

Dry eyes, dermatological conditions - rosacae and demodex infestation

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3
Q

Cause of blepharitis

A

Staph blepharitis and meibomian gland dysfunction are most common causes

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4
Q

Symptoms of blepharitis

A

Redness
Burning sensation
Irritation
Tearing
Eyelid crusting and sticking
Visual problems such as photophobia and blurred vision

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5
Q

What time of day is blepharitis typically worse

A

In the morning

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6
Q

Signs of blepharitis

A

Meibomian glands may appear capped with oil
Dilated, visibly obstructed
Erythema, oedema
May exhibit eyelash loss and/or misdirection

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7
Q

Management of blepharitis

A

Warm compresses, eyelid massage, eyelid scrubs, topical Abx, oral Abx, lubricating eye drops, artificial tears, short courses of topical steroids

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8
Q

Oral Abx which could be used in blepharitis

A

Tetracycline and doxycycline

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9
Q

When are oral Abx used in patients with blepharitis

A

Those with meibomian gland dysfunction or patients associated with rosacea

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10
Q

Options for lubricating eyedrops in patients with blepharitis

A

Hypromellose, polyvinyl alcohol, carbomer

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11
Q

What can blepharitis lead to

A

Styes and chalazions

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12
Q

When can short courses of topical steroids be used in blepharitis

A

Beneficial for symptomatic relief in cases with significantly ocular inflammation

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13
Q

What is a stye

A

Tender red lump along the eyelid that may contain pus

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14
Q

What is hordeolum externum

A

Infection of the glands of Zeis or glands of Moll

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15
Q

What is hordeolum internum

A

Infection in the Meibomian glands

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16
Q

What are the glands of Moll

A

Sweat glands at the base of the eyelashes

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17
Q

What are the glands of Zeis

A

Sebaceous glands at the base of the eyelashes

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18
Q

Treatment of a stye

A

Hot compresses and analgesia. Consider topical antibiotics (chloramphenicol) if it associated with conjunctivitis or if persistent

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19
Q

What is chalazion

A

Chronic sterile lipogranuloma in the eyelid that originates from an obstructed meibomian gland of the tarsal plates

20
Q

Risk factors for chalazion

A

Blepharitis, rosacea, prior chalazion, dermodicosis

21
Q

Symptoms of chalazion

A

Gradually enlarging eyelid nodule, eyelid discomfort, even painful swelling if secondary infection occurs, history of similar eyelid swelling in the past

22
Q

Signs of chalazion

A

Nodule on an eyelid, affects upper eyelids more (due to their being more meibomian glands)

23
Q

Investigations into chalazion

A

Recurrent or atypical chalazia should be sent for pathologic evaluation, microscopy of the materials from a chalazion shows a lipogranulomatous

24
Q

Management if chalazion small and asymptomatic

A

Left untreated, lid massage, warm compression, Abx steroid eye drops or ointments

25
Q

Management of chalazion is associated with inflammatory conditions

A

Topical Abx eyedrops

26
Q

When is surgical treatment involved in chalazion

A

Unresolved or large and symptomatic. Incision and curettage

27
Q

What is entropion

A

Eyelid turns inwards with the lashes against the eyeball.

28
Q

What is ectropion

A

Eyelid turns outwards with the inner aspect of the eyelid exposed, usually affects the bottom lid

29
Q

What is the end result of entropion

A

Results in pain and can result in corneal damagae and ulceration

30
Q

What is the end result of ectropion

A

Result in exposure keratopathy as the eyeball is exposed and not adequately lubricated and protected

31
Q

Management of entropion

A

Taping the eyelid down to prevent it turning inwards. Definitive management is with surgical intervention, also using regular eye drops

32
Q

Management of ectropion

A

mild cases require no treatment, regular lubricating eye drops are used to protect the surface of the eye, more significant require surgery

33
Q

What is trichiasis

A

Inward growth of eyelashes, this results in pain and can result in corneal damage and ulceration

34
Q

Management of trichiasis

A

Specialist to remove the eyelash, recurrent cases may require electrolysis, cryotherapy or laser treatment to prevent lash regrowing

35
Q

What is blepharoptosis

A

Abnormal low lying upper eyelid margin with the eye in primary gaze.

36
Q

Symptoms of blepharoptosis

A

Usually present with eye being small, tired appearance, limited field of vision and headache

37
Q

Investigations into blepharoptosis

A

Visual acuity, pupillary reflexes, ocular motility, marginal reflex distance, levator functions, proptosis, enopthalmos, logophthalmos, presence of Bell phenomenon

38
Q

Medical therapy of patients with blepharoptosis

A

Patients with myasthenia gravis may improve with medical therapy such as sympathomimetic topical eye drops

39
Q

Eg of sympathomimetic topical eye drops

A

apraclonidine and phenylephrine

40
Q

When is early surgical intervention required

A

If there is a risk of the patient developing ambylopia or significant abnormal head position to develop

41
Q

What is the main treatment for ptosis

A

Surgical - levator resection (good levator function) or frontalis suspension (poor levator function). Mullerectomy in mild ptosis

42
Q

Causes of acquired ptosis

A

Aponeurotic or involutional ptosis may result from stretching, disinsertion of the levator aponeurosis. Myogenic ptosis, neurogenic ptosis, mechanical ptosis.

43
Q

Myogenic causes of ptosis

A

Myasthenia gravis

44
Q

Neurogenic causes of ptosis

A

3rd nerve palsy or Horner’s syndrome

45
Q

Mechanical causes of ptosis

A

Result from presence of eyelid mass, such as neurofibroma or haemangioma

Ophthalmology (17 decks)

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