Eyelid Disorders

Question 1

red flags

Answer 1

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

Question 2

treatment goals for infection

Answer 2

cure
prevent transmission
prevent recurrence

Question 3

treatment goals for dry eye

Answer 3

manage symptoms
prevent complication
identify exacerbating factors

Question 4

symptoms of a stye

Answer 4

unilateral
localized lid swelling
tenderness
red

Question 5

difference between external and internal stye appearance

Answer 5

external- smaller more superficial and points toward skin

internal- larger and more discomfort point to skin or conjunctiva

Question 6

when should external stye resolve

Answer 6

should drain in 48 hous or refer because may need antibiotics

Question 7

when should internal stye resolve

Answer 7

1-2 weeks should drain on own if not resolved in 1 week refer because may require prescription ointment

Question 8

treatment for styes

Answer 8

warm compresses for 10 minutes 3-4 times daily

Question 9

prevention of styes

Answer 9

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

Question 10

how is a chalazion idfferent from a stye

Answer 10

inflammation not infection
chronic
develops over period of weeks

Question 11

description of chalazion

Answer 11

lesion point between conjunctival surface

painless localized redness and swelling

Question 12

treatment for chalazion

Answer 12

warm compress 10 min 3-4 times daily
eyelid massage
resolves spontanously

Question 13

when should you refer chalazion

Answer 13

no improvement within 24 hours of treatment

visual disturbance or painful

Question 14

describe blepharitis

Answer 14

chronic inflammation of eyelids
associated with acne rosacea and seborrheic dermatitis
not contagious

Question 15

symptoms of blepharitis

Answer 15

usually bilateral 
red swollen itchy lid margins 
eyes rad and watery 
EYELID SCALY 
burnign 
sandy or gritty feeling worsens upon awakening 
loss of lashes

Question 16

blepharitis exacerbations and initial diagnosis is a referral because it requires prescription products but what are some non pharms

Answer 16

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

Question 17

what is conjunctivitis

Answer 17

inflammatory condition of conjuctiva - mucous membrane lining the back of the eyelid and front of eye

Question 18

who should be referred for acute bacterial conjunctivitis

Answer 18

children adn contact lens wearers due to higher risk

Question 19

symptoms of acute bacterial conjuntivitis

Answer 19

unilateral 
mild to moderate foreign body sensation 
minimal itching 
redness 
creamy white or pale yellow discharge 
EYELIDS STICK TOGETHER UPON WAKENING 
crustin on eyelids

Question 20

adult treatment of acute bacterial conjunctivitis

Answer 20

polymyxinB/gramicidin drops 4-6 times daily for 7-10 days
warm compresses in the morning
continue for 2 days after symptoms resolved

Question 21

what causes hyperacute bacterial conjunctivitis

Answer 21

n.gonorrhea or nmeningtidis

seen in neonates or from sex

Question 22

signs of hyperacute bacterial conjunctivitis and treatment

Answer 22

copious yellow/greean purulent discharge
red, irritation, tender
immediate referral to emergency room because severe and sight threatening

Question 23

what is chronic bacterial conjuntivitis

Answer 23

lasts longer than 4 weeks that requires referral bc need antibiotics

Question 24

non pharms for chronic bacterial conjuntivitis

Answer 24

warm compresses
lid scrubs
avoid contaminated products

Question 25

symptoms of viral conjunctivitis

Answer 25

acute red eye, conjunctival swelling, soreness, mild pain, minimal itching, profuse watery clear discharge, foreign body sensation. mild photophobia may have upper respiratory infection

Question 26

viral conjunctivitis is a referral what other things should you recommend

Answer 26

cold compresses ocular lubricants avoid direct contact for 14 days or more after onset of symptoms (children no school at least a week)

Question 27

symptoms of allergic conjunctivitis

Answer 27

``` 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 ```

Question 28

non pharms for allergic conjunctivitis

Answer 28

allergen avoidance | cold compresses 10 min 3-4 times daily to help redness and itching

Question 29

treatment options fo rallergic conjunctivitis

Answer 29

ocular lubricants for symptomatic relief | oral antihistamines stops itch not redness

Question 30

cautions with ocular decongestants

Answer 30

rebound ocular congestion dont exceed 3-5 days | avoid in narrow angle glaucome and uncontrolled hypertension

Question 31

how do you use ocular lubricants and whatdo they do

Answer 31

1 drop 2-6 times daily | dilutes allergen amd decreases allergen contact time with conjunctive

Question 32

examples of ophthalmic decongestants

Answer 32

phenylephrine | imidazoles

Question 33

example of opthalmic mast cell stabilizer

Answer 33

sodium cromoglycate

Question 34

what do opthalmic mast cell stabilizers do

Answer 34

block histamine from mast cells | prevent redness, itching, and eyelid swelling

Question 35

when should opthalmic mast cell stabilizers be started

Answer 35

must be started before allergy season to prevent symptoms because takes 10 days for max effect

Question 36

risk factors for dry eye

Answer 36

``` low humidity, high temp over 40 occupation- computer, planes contact lens meds-anticholinergics, beta blockers, diuretics RA, sjogrens ```

Question 37

symptoms of dry eyes

Answer 37

``` foreign body sensation redness itchy scratchy burn or stinging gritty tired dry excessive tearing general discomfort photophobia blured vision * worsen throughout day ```

Question 38

dry eye treatment goals

Answer 38

manage symptoms prevent complications determine severity rule out other ocular complications

Question 39

non pharms for dry eyes

Answer 39

use humidifier avoid prolonged viewing of screens avoid outdoor windy environments without protection cool moist compresses over closed eyelids tear duct occlusion

Question 40

pharm treatment for dry eye

Answer 40

ocular lubricants artificial tears or lubricating ointments at night

Question 41

when to refer dry eye

Answer 41

symptoms dont resolve in 3-5 days or if worsen see doctor | stinging and inflammation due to preservative switch to preservative free

Question 42

expected improvement of each condition

Answer 42

eyelid and acute bacterial conjunctivitis - 48hr allergic - 72hr dry eye 3-5 days