eyelid disorders

Question 1

what is blepharitis?

Answer 1

inflammation of eyelid margins

Question 2

what are features of blepharitis?

Answer 2

gritty and itch, dry sensation
crusted eyelids
redness around
can be greasy around

Question 3

what is the pathology of blepharitis?

Answer 3

associated to dysfunction of meibomian glands - they are responsible for secreting meibum (oil) onto surface of eye

Question 4

what can blepharitis lead to?

Answer 4

styes and chalazions

Question 5

what is a stye?

Answer 5

aka hordeolum externum
infection of glands of zeis or glands of moll

Question 6

what are the glands of moll

Answer 6

sweat glands at base of eyelashes

Question 7

what are glands of zeis?

Answer 7

sebaceous glands at base of eyelashes

Question 8

how does a stye present?

Answer 8

tender red lump along eyelid
may contain pus

Question 9

what is hordeolum internum?

Answer 9

infection of meibomian glands
deeper and tend to be more painful then normal styes
point inward towards eyeball

Question 10

how do you manage blepharitis?

Answer 10

warm compress and gentle cleaning to remove debris

Question 11

how are styes managed?

Answer 11

hot compress and analgesia
topical antibiotics - chloramphenicol may be considered if associated with conjunctivitis

Question 12

what is a chalazion?

Answer 12

meibomian gland becomes blocked and swells - meibomina cyst

Question 13

how does chalazion present?

Answer 13

swelling of eyelid not usually tender but can be red and tender

Question 14

how do you manage chalazion?

Answer 14

warm compresses and gentle massage towards eyelashes - encourage drainage
rarely - surgical drainage

Question 15

what is entropion?

Answer 15

eyelid turns inwards with lashes towards eyeball

Question 16

what can entropion cause?

Answer 16

pain
corneal damage and ulceration

Question 17

how do you manage entropion?

Answer 17

taping eyelid down to prevent turning inward
definite - surgical
lubricating eye drops - to prevent dryness when taped down

Question 18

what is ectropion?

Answer 18

eyelid turned outwards
usually bottom lid - can see more red

Question 19

what can ectropion result in?

Answer 19

exposure keratopathy - eyeball is exposed and not adequately lubricated and protected

Question 20

how do you manage ectropion?

Answer 20

mild - nothing
regular eye lubricating drops
significant - surgery

Question 21

what is trichiaisis?

Answer 21

inward growth of eyelashes

Question 22

what does trichiasis present as?

Answer 22

pain
corneal damage and ulceration

Question 23

how do you manage trichiasis?

Answer 23

removing affected lashes
recurrent - electrolysis, cryotherapy or laser treatment

Question 24

what is periorbital cellulitis?

Answer 24

eyelid and skin infection

Question 25

how does periorbital cellulitis present?

Answer 25

swollen red hot skin around eyelid and eye

Question 26

how should periorbital cellulitis be differentiated to orbital?

Answer 26

orbital - sight and life threatening need urgent ophthalmology referral CT can distinguish

Question 27

how do you manage periorbital cellulitis?

Answer 27

oral flucloxacillin IV if systemically unwell

Question 28

what is orbital cellulitis?

Answer 28

infection around eyeball involving tissues behind - orbital septum

Question 29

what are the symptoms of orbital cellulitis?

Answer 29

pain within eye movement reduced eye movement vision changes ABnormal pupil reactions proptosis

Question 30

what is proptosis?

Answer 30

eyes bulging forward - seen in graves

Question 31

how is orbital cellulitis managed?

Answer 31

emergency admission under opthalamology IV co - amox may need vancomycin may need surgical drainage

Question 32

what is conjuctivitis?

Answer 32

inflammation of conjucntiva

Question 33

what is the aetiology of conjuctivitis?

Answer 33

bacterial, viral, allergic unilateral or bilateral

Question 34

how might conjunctivitis present?

Answer 34

red, blood shot eye itchy, gritty sensation discharge NO pain, photophobia, reduced visual acuity

Question 35

can discharge from eye from conjuctivitis affect vision?

Answer 35

might make blurry once cleared - sight restored if not restored -- different differential

Question 36

how does bacterial conjunctivitis present?

Answer 36

purulent discharge worse in morning eyes may be stuck together usually starts in one and spreads to other highly contagious

Question 37

how does viral conjunctivitis present?

Answer 37

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

Question 38

how is conservatively conjunctivitis managed?

Answer 38

usually resolves in 1-2weeks without needing treatment hygiene - avoid towel sharing, clean eyes with cooled boiled water

Question 39

if necessary, how may you treat bacterial conjuctivitis?

Answer 39

chloramphenicol or fusisidic acid eye drops

Question 40

how should neonates with conjunctivitis be managed?

Answer 40

urgent opthalamolgy may be caused by gonoccocal infection - serious complications

Question 41

what is allergic conjuctivitis?

Answer 41

conjuctivitis caused by contact to allergens

Question 42

how does allergic conjuctivitis present?

Answer 42

swelling of conjuctival sac and eyelid itching watery discharge

Question 43

how can you manage allergic conjuctivitis?

Answer 43

antihistamines - oral/ topical topical mast cell stabilisers

Question 44

give an example of a mast cell stabiliser?

Answer 44

sodium cromoglicate

Question 45

what is the MOA of topical mast cell stabilisers?

Answer 45

prevent mast cells from releasing histamines