Eyelid Disorders

Question 1

1. What condition is inflammation of the eyelid margins?
2. What is it caused by?
3. Features of it?
4. Management
5. What can this condition lead to?

Answer 1

1. Blepharitis
2. Caused by Meibomian gland dysfunction which secretes meibum (oil) onto surface of eye
3. Gritty, dry sensation in eyes
4. Manage with warm compress and gentle cleaning of eyelid margins with baby shampoo/cotton bud to remove debris
5. Styes/chalazions

Question 2

How do you treat a stye?

Features of a stye

Answer 2

Hot compresses and analgesia
If symptoms persistent or has assoc. conjunctivitis -> give topical chloramphenicol abx

Tender red swelling on eyelid margin with/without pus

Question 3

What is the condition where a Meibomian gland gets blocked?

Features of it?

Management?

Answer 3

Chalazion

Non tender/tender red swelling in the eyelid

Warm compresses and gentle massage towards eyelashes to encourage drainage OR surgical drainage

Question 4

Whats the condition where the eyelid turns inwards and lashes press up against the eye?

Management?

Complications of this?

Answer 4

Entropion

Taping the eyelid down, surgical management is definitive, same day ophthalm referral if risk to sight

Corneal damage and corneal ulceration

Question 5

Whats the condition where the eyelid turns outwards?

Management?

Complications of this?

Answer 5

Ectropion

Mild cases -> no treatment.
Lubricating eye drops
Surgery
Same day ophthalm referral if risk to sight

Exposure keratopathy

Question 6

Whats the condition where the eyelashes grow inwards?

Management?

Answer 6

Trichiasis

Manage with electrolysis, cryotherapy, laser treatment to prevent regrowth.
Same day ophthalm referral if risk to sight

Question 7

What is the condition where there is infection in eyelid and skin tissues anterior to orbital septum?

Symptoms?

Management

Answer 7

Periorbital cellulitis

Swollen red hot skin on eyelid and around eye

Oral/IV abx. Admit children as it can progress to orbital cellulitis

Question 8

1. What is the condition where there is infection in the orbital fat and orbital muscles?
2. Who is it more common in?
3. Symptoms?
4. Management of it?

Answer 8

1. Orbital cellulitis
2. Children
3. Pain on eye movement
   Reduced eye movements
   Vision changes
   Abnormal pupil changes
   Proptosis
4. Emergency admission under ophthalm
   IV Abx
   Surgical drainage if abscess forms

Question 9

1. Which is more serious: orbital or periorbital cellulitis?
2. How to differentiate between them?

Answer 9

1. Orbital
2. CT scan