Eyelid Disorders Flashcards
Pterygium
risk factors
- increased UV light exposure in sunny climates
- sand, wind, dust exposure
Pterygium
clinical presentation
4 components
- elevated, superficial fleshy, triangular-shaped growing mass
- starts medially & extends laterally
- irritation, erythema, foreign body sensation
- can impair vision
Pterygium
management
3 components
- observation
- artificial tears
- surgical removal once vision is impaired
Pterygium
what can occur with recurrent pterygium
can cause sx more quickly resulting in more surgery and increased scarring
Pinguecula
risk factors
2
- eye irritation (dry, windy, sunny conditions)
- ocular trauma
Pinguecula
clinical manifestations
4 components
- yellow
- slightly elevated nodule
- found on nasal side of sclera
- does not grow onto cornea
Pinguecula
management
2
- no tx necessary
- cosmetic: resection
Hordeolum
most common bacteria
s. aureus
Hordeolum
pathophys of internal infection
inflammation or infection of a meibomian gland found deep from the palpebral margin under the eyelid
Hordeolum
pathophys of external infection
infection of an eyelash follicle or sebaceous gland near the lid margin w/ production of pus in the gland of Moll or Zeis
Hordeolum
clinical manifestations
5
- localizaed erythema
- painful
- warm
- tender
- nodular/pustule on the eyelid
Hordeolum
management
- warm compress
- may need I&D or abx ointment
Hordeolum
which abx ointment to use
erythromycin or bacitracin
Chalazion
pathophys
obstruction of Zeis or Meibomian glans
Chalazion
clinical manifestations
3
- non-tender (PAINLESS)
- localized edema
- conjunctival nodule
Chalazion
management
2 components
- eyelid hygiene
- warm compress
Chalazion
what to do if refractory?
- refer to ophthalmology
- glucocorticoid infection or I&D
Chalazion vs Hordeolum
Chalazion is larger, firmer, slower growing, less painful than hordeolum
Ectropian
risk factors
4
- elderly
- CN 7 palsy
- congential
- infectious
Ectropian
pathophys
relaxation of orbicularis oculi muscle
Ectropian
PE findings
eyelid/lashes are everted (turned outward)
Ectropian
clinical findings
5
- irritation
- ocular dryness
- tearing
- sagging of eyelid
- increased sensitivity
Ectropian
management
3
- lubricating eyedrops
- moisture shield
- surgical correction
Entropion
risk factors
elderly
Entropion
pathophys
spasm of the orbicularis oculi muscle
Entropion
PE findings
eyelid and lashes are inverted (turned inward)
Entropion
clinical presentation
4 components
- erythema
- tearing
- increased sensitivity
- corneal abrasion/ulceration
Entropion
management
- lubricating eyedrops
- moisture shield
- surgical correction
Blepharitis
risk factors
4
- down syndrome
- atopic dermatitis
- rosacea
- seborrheic dermatitis
Blepharitis
pathophys of anterior
- commonly infectious/viral in naure (s. aureus or s. epidermis)
- can also be seborrheic
Blepharitis
pathophys of posterior
meibomian gland dysfunction
Blepharitis
clinical manifestations
6
- burning
- erythema
- crusting/scaling
- red rimming of the eyelid
- gritty sensation
- flaking on the lashes/lid margins
Blepharitis
potential PE finding
+/- entropion or ectropion
Blepharitis
management
- eyelid hygiene (warm compress, scrub, massage, artificial tears)
Blepharitis
what to use if severe or refractory
2
- abx (erythromycin, azithromycin, ofloxacin)
- topical glucocorticoid
Dacrocystitis
common etiologies
4
- s. epidermis
- s. aureus
- GABHS
- pseudomonas
Dacrocystitis
risk factors
2
- sjorgen syndrome
- thyroid disease
Dacrocystitis
pathophys
obstruction of the nasolacrimal duct
Dacrocystitis
clinical manifestations of acute disease
6
- tenderness/pain
- tearing
- erythema
- edema
- warm to touch (medial canthal side/lower lid area)
- +/- purulent discharge
Dacrocystitis
clinical manifestation of chronic
1 additional
mucopurulent drainage from puncta
Dacrocystitis
management acute
abx PO (clindamycin) + warm compress
Dacrocystitis
management of chronic
dacrocystorhinostomy
Viral Conjunctivitis
most common in who
children
Viral Conjunctivitis
mode of transmission
direct contact
Viral Conjunctivitis
common source
swimming pools
Viral Conjunctivitis
clinical manifestations
5
- bilateral
- foreign body sensation/gritty
- ocular erythema
- tearing/watery discharge
- itching
Viral Conjunctivitis
how is vision?
unimpacted