Eyelid Disorders Flashcards
red flags
blunt trauma foreign particles ocular abrasion chemical thermal blurred vision pain sensitive to light redness around cornea abonormal pupil more than 48 hours contact lens wearers with conjuntivitis
treatment goals for infection
cure
prevent transmission
prevent recurrence
treatment goals for dry eye
manage symptoms
prevent complication
identify exacerbating factors
symptoms of a stye
unilateral
localized lid swelling
tenderness
red
difference between external and internal stye appearance
external- smaller more superficial and points toward skin
internal- larger and more discomfort point to skin or conjunctiva
when should external stye resolve
should drain in 48 hous or refer because may need antibiotics
when should internal stye resolve
1-2 weeks should drain on own if not resolved in 1 week refer because may require prescription ointment
treatment for styes
warm compresses for 10 minutes 3-4 times daily
prevention of styes
wash ahnds before and after contact with eye
avoid touching eyes
change towels after use
avoid touching eyes when using eye drops
avoid use of eye cosmetics
treat blepharitis if present
how is a chalazion idfferent from a stye
inflammation not infection
chronic
develops over period of weeks
description of chalazion
lesion point between conjunctival surface
painless localized redness and swelling
treatment for chalazion
warm compress 10 min 3-4 times daily
eyelid massage
resolves spontanously
when should you refer chalazion
no improvement within 24 hours of treatment
visual disturbance or painful
describe blepharitis
chronic inflammation of eyelids
associated with acne rosacea and seborrheic dermatitis
not contagious
symptoms of blepharitis
usually bilateral red swollen itchy lid margins eyes rad and watery EYELID SCALY burnign sandy or gritty feeling worsens upon awakening loss of lashes
blepharitis exacerbations and initial diagnosis is a referral because it requires prescription products but what are some non pharms
warm compresses 10 min
gentle scrubbing of lid margin - commercial eyelid scrubs or a cotton swab dipped in solution of baby shampoo in warm water once or twice daily
what is conjunctivitis
inflammatory condition of conjuctiva - mucous membrane lining the back of the eyelid and front of eye
who should be referred for acute bacterial conjunctivitis
children adn contact lens wearers due to higher risk
symptoms of acute bacterial conjuntivitis
unilateral mild to moderate foreign body sensation minimal itching redness creamy white or pale yellow discharge EYELIDS STICK TOGETHER UPON WAKENING crustin on eyelids
adult treatment of acute bacterial conjunctivitis
polymyxinB/gramicidin drops 4-6 times daily for 7-10 days
warm compresses in the morning
continue for 2 days after symptoms resolved
what causes hyperacute bacterial conjunctivitis
n.gonorrhea or nmeningtidis
seen in neonates or from sex
signs of hyperacute bacterial conjunctivitis and treatment
copious yellow/greean purulent discharge
red, irritation, tender
immediate referral to emergency room because severe and sight threatening
what is chronic bacterial conjuntivitis
lasts longer than 4 weeks that requires referral bc need antibiotics
non pharms for chronic bacterial conjuntivitis
warm compresses
lid scrubs
avoid contaminated products
symptoms of viral conjunctivitis
acute red eye, conjunctival swelling, soreness, mild pain, minimal itching, profuse watery clear discharge, foreign body sensation. mild photophobia
may have upper respiratory infection
viral conjunctivitis is a referral what other things should you recommend
cold compresses
ocular lubricants
avoid direct contact for 14 days or more after onset of symptoms (children no school at least a week)
symptoms of allergic conjunctivitis
bilateral sever ocular itching minimal redness tearing no sign of infection no foreign body sensation history of allergies or seasonal allergic rhinitis accompanied with runny nose and sneezing
non pharms for allergic conjunctivitis
allergen avoidance
cold compresses 10 min 3-4 times daily to help redness and itching
treatment options fo rallergic conjunctivitis
ocular lubricants for symptomatic relief
oral antihistamines stops itch not redness
cautions with ocular decongestants
rebound ocular congestion dont exceed 3-5 days
avoid in narrow angle glaucome and uncontrolled hypertension
how do you use ocular lubricants and whatdo they do
1 drop 2-6 times daily
dilutes allergen amd decreases allergen contact time with conjunctive
examples of ophthalmic decongestants
phenylephrine
imidazoles
example of opthalmic mast cell stabilizer
sodium cromoglycate
what do opthalmic mast cell stabilizers do
block histamine from mast cells
prevent redness, itching, and eyelid swelling
when should opthalmic mast cell stabilizers be started
must be started before allergy season to prevent symptoms because takes 10 days for max effect
risk factors for dry eye
low humidity, high temp over 40 occupation- computer, planes contact lens meds-anticholinergics, beta blockers, diuretics RA, sjogrens
symptoms of dry eyes
foreign body sensation redness itchy scratchy burn or stinging gritty tired dry excessive tearing general discomfort photophobia blured vision * worsen throughout day
dry eye treatment goals
manage symptoms
prevent complications
determine severity rule out other ocular complications
non pharms for dry eyes
use humidifier
avoid prolonged viewing of screens
avoid outdoor windy environments without protection
cool moist compresses over closed eyelids
tear duct occlusion
pharm treatment for dry eye
ocular lubricants artificial tears or lubricating ointments at night
when to refer dry eye
symptoms dont resolve in 3-5 days or if worsen see doctor
stinging and inflammation due to preservative switch to preservative free
expected improvement of each condition
eyelid and acute bacterial conjunctivitis - 48hr
allergic - 72hr
dry eye 3-5 days
