Eyelid disorders Flashcards
Where are the meibomian glands found
embedded in connective tissue of tarsi plates
What lines the posterior eyelid
palpebral conjunctiva composed of epithelium and sub epithelial stroma
Where are goblet cells contained in the eyelid
epithelium of tarsi
What is a Hordeolum
Stye
What is the clinical presentation of a chalazion
Initial diffuse swelling of eyelid
-1-2 days will localize to eyelid body
-drains through inner eyelid surface
-spontaneously absorbs in 2-8 weeks
What causes hordeolum
Infectious, painful localized swelling to the eyelid margin
What is a chalazion
Non-infectious obstruction of the meibomian gland causing irritation of lipid material in eyelid and soft tissue
What are some risk factors for chalazions
Meibomian gland disfunction
acne
rosacea
What side effect outside of eyelid swelling can a chalazion cause
indentation of the cornea causing blurred vision
What type of infection causes hordeolum
Pyogenic staph infection
Where are hordeolum found on the eye
external from obstruction/infection of eyelash follicle and adjacent gland (Zeis and moll glands)
What is the clinical presentation of an external hordeolum
1-2 days of tearing, photophobia, foreign body sensation
-small yellow pustule surrounded by hyperemia
-w/n 2-4 days lesion will rupture
When is an internal hordeolum suspected
severe inflammation
fever
chills
When do chalazion require bx and why
When they are chronic and dont respond to treatment
need to exclude tumor of eyelid
When is treatment required for chalazion and what is it
Incision & curettage / intra-chalazion corticosteroid therapy w/ triamcinolone
when large, unsightly and going on for several weeks despite conservative tx
When is treatment required for external hordeolum and what is it
When not responding to hot compress
incise with sharp and give doxy or erythromycin when cellulitis present
What is the treatment for internal hordeolum
oral abx and I&D
What is blepharitis
inflammation of eyelid margin
*can be acute or chronic
What are the s/sx of blepharitis
itching and burning of eyelid margin with redness and edema
How do you treat acute ulcerative blepharitis
topical antibiotics
or
systemic antivirals
How is acute non-ulcerative blepharitis treated
occasionally with topical corticosteroid
How is chronic blepharitis treated
tear supplements
warm compress
What is the cause of acute blepharitis
generally a staph infection at origin of eyelashes
*could have viral source (HSV, VZV)
How can you tell the difference between bacterial and viral blepharitis
bacterial generally has more crusting than viral
What is the cause of acute non-ulcerative blepharitis
allergic reaction
How is blepharitis generally worked up/ diagnosed
slit lamp exam
How do you treat acute ulcerative blepharitis
abx ointment
-bacitracin/polymyxin B, erythromycin, gentamicin 7-10 days
How do you treat acute viral ulcerative blepharitis
Acyclovir for 7 days
How do you treat acute non-ulcerative blepharitis
avoid offending action/substance
warm compress
if swelling persists >24hrs ophthalmic ointment for 7 days
how do you treat seborrheic blepharitis
cleansing of eyelid margin with dilute baby shampoo
What is inversion of the eyelid
Entropin
What is eversion of lower eyelid
ectropion
What causes entropion
Age related tissue relaxation
What is a definitive treatment of entropion
surgery
What are the symptoms of entropion
foreign body sensation
tearing
red eye
What causes ectropion
age related tissue relaxation
posttraumatic
CN VII palsy
What are the symptoms of ectropion
tearing
dry eye sx
How do you treat ectropion
Surgery = definitive
tear supplements
ocular lubricants at night
What is dacrocystitis
infection of lacrimal sac that may cause abscess formation
What is the cause of dacrocystitis
Staph or strep in nasolacrimal duct
How do you diagnose dacrocystitis
when pressure is placed on the lesion, mucoid material will leak through puncta
How do you treat dacrocystitis
Mild = warm compress
severe = 1st gen cephalosporin IV
How do you treat chronic dacrocystitis
surgery
What is the most common malignant eyelid tumor
basal cell carcinoma in caucasians
Sebaceous gland carcinoma in asians
What is the most common benign epithelial tumor
squamous papilloma
What are benign epithelial eyelid tumors
keratocanthoma
seborrheic keratosis
cutaneous horn
squamous papilloma
What is the most precancerous lesion on the eyelid
actinic keratosis (turn into SCC)
What are benign melanocytic eyelid tumors
freckles
lentigo simplex
solar lentigo
eyelid nevi
Who is at risk for developing cutaneous melanoma of eyelid
fair skinned adults
history of UV radiation
What are cystic eyelid tumors
epidermal inclusion
sweat gland tumor
hair follicle tumor
stromal tumor
xanthelasma
What is the main difference with BCC and SCC
BCC is generally found inner and lower eyelid
SCC is generally upper and outer eyelid
What is xanthelasma
Common benign deposit of yellow-white flat plaques of lipid material SQ of upper and lower lid
Which population are xanthelasma most common
middle age- elderly
What are vascular tumor of the eyelid
capillary hemangioma
nevus flameus
kaposi’s sarcoma
Which eyelid tumor can be described as a port wine stain
nevus flameus
What is the most common vascular tumor of the eyelid
capillary hemangioma
What is a neurogenic eyelid tumor
solitary neurofibroma (may resemble chalazion)
