eyelid disorders Flashcards
what is blepharitis?
inflammation of eyelid margins
what are features of blepharitis?
gritty and itch, dry sensation
crusted eyelids
redness around
can be greasy around
what is the pathology of blepharitis?
associated to dysfunction of meibomian glands - they are responsible for secreting meibum (oil) onto surface of eye
what can blepharitis lead to?
styes and chalazions
what is a stye?
aka hordeolum externum
infection of glands of zeis or glands of moll
what are the glands of moll
sweat glands at base of eyelashes
what are glands of zeis?
sebaceous glands at base of eyelashes
how does a stye present?
tender red lump along eyelid
may contain pus
what is hordeolum internum?
infection of meibomian glands
deeper and tend to be more painful then normal styes
point inward towards eyeball
how do you manage blepharitis?
warm compress and gentle cleaning to remove debris
how are styes managed?
hot compress and analgesia
topical antibiotics - chloramphenicol may be considered if associated with conjunctivitis
what is a chalazion?
meibomian gland becomes blocked and swells - meibomina cyst
how does chalazion present?
swelling of eyelid not usually tender but can be red and tender
how do you manage chalazion?
warm compresses and gentle massage towards eyelashes - encourage drainage
rarely - surgical drainage
what is entropion?
eyelid turns inwards with lashes towards eyeball
what can entropion cause?
pain
corneal damage and ulceration
how do you manage entropion?
taping eyelid down to prevent turning inward
definite - surgical
lubricating eye drops - to prevent dryness when taped down
what is ectropion?
eyelid turned outwards
usually bottom lid - can see more red
what can ectropion result in?
exposure keratopathy - eyeball is exposed and not adequately lubricated and protected
how do you manage ectropion?
mild - nothing
regular eye lubricating drops
significant - surgery
what is trichiaisis?
inward growth of eyelashes
what does trichiasis present as?
pain
corneal damage and ulceration
how do you manage trichiasis?
removing affected lashes
recurrent - electrolysis, cryotherapy or laser treatment
what is periorbital cellulitis?
eyelid and skin infection
how does periorbital cellulitis present?
swollen red hot skin around eyelid and eye
how should periorbital cellulitis be differentiated to orbital?
orbital - sight and life threatening
need urgent ophthalmology referral
CT can distinguish
how do you manage periorbital cellulitis?
oral flucloxacillin
IV if systemically unwell
what is orbital cellulitis?
infection around eyeball involving tissues behind - orbital septum
what are the symptoms of orbital cellulitis?
pain within eye movement
reduced eye movement
vision changes
ABnormal pupil reactions
proptosis
what is proptosis?
eyes bulging forward - seen in graves
how is orbital cellulitis managed?
emergency admission under opthalamology
IV co - amox
may need vancomycin
may need surgical drainage
what is conjuctivitis?
inflammation of conjucntiva
what is the aetiology of conjuctivitis?
bacterial, viral, allergic
unilateral or bilateral
how might conjunctivitis present?
red, blood shot eye
itchy, gritty sensation
discharge
NO pain, photophobia, reduced visual acuity
can discharge from eye from conjuctivitis affect vision?
might make blurry
once cleared - sight restored
if not restored – different differential
how does bacterial conjunctivitis present?
purulent discharge
worse in morning
eyes may be stuck together
usually starts in one and spreads to other
highly contagious
how does viral conjunctivitis present?
common and usually presents with clear discharge
general viral symptoms - dry cough, sore throat etc
may have peri-auricular lymph nodes - in front of ears
contagious
how is conservatively conjunctivitis managed?
usually resolves in 1-2weeks without needing treatment
hygiene - avoid towel sharing, clean eyes with cooled boiled water
if necessary, how may you treat bacterial conjuctivitis?
chloramphenicol or fusisidic acid eye drops
how should neonates with conjunctivitis be managed?
urgent opthalamolgy
may be caused by gonoccocal infection - serious complications
what is allergic conjuctivitis?
conjuctivitis caused by contact to allergens
how does allergic conjuctivitis present?
swelling of conjuctival sac and eyelid
itching
watery discharge
how can you manage allergic conjuctivitis?
antihistamines - oral/ topical
topical mast cell stabilisers
give an example of a mast cell stabiliser?
sodium cromoglicate
what is the MOA of topical mast cell stabilisers?
prevent mast cells from releasing histamines
