Eyelid Disorders Flashcards
What is blepharitis?
Inflammation of the eyelid margins
What can blepharitis lead to?
Chalzions and styes
Presentation of blepharitis?
Gritty, itchy, dry sensation in eyes
What can blepharitis be associated with?
Dysfunction of Meibomian glands
What are Meibomian glands?
Responsible for secreting oil onto eye surface
Management of blepharitis?
Hot compress
Gentle cleaning of the eyelid margins to remove debris using cotton wool dipped in sterilised water & baby shampoo
What can be used for symptomatic relief in Blepharitis?
Lubricating eye drops
Different types of eye drops for lubrication?
Hypromellose drops (Least viscous) Polyvinyl alcohol drops Carbomer drops (last 30-60 mins, most viscous)
2 types of stye?
Hordeolum externum:
Hordeollum internum
What is hordeolum externum?
Infection of the glands of Zeus or glands of Moll
Presentation of hordeolum externum?
Tender red lump along eyelid + possible pus
What and where are the glands of Zeis?
Sebaceous glands @ base of eyelash
What and where are the glands of Moll?
Sweat glands at base of eyelashes
What is hordeolum internum?
Infection of Meibomian glands?
Presentation of hordeolum internum?
Deeper, more painful and may point inwards toward eyeball, underneath eyelid
Management of styes?
Hot compress and analgesia
Consider topic antibiotics eg chloramphenicol if associated with conjunctivitis or symptoms are persistent
What is a chalzion?
Often called a Meibomian cyst
Why does a chalzion occur?
When a Meibomian gland becomes blocked & swells
Presentation of a chalzion?
Swelling in eyelid, typically not tender however can sometimes be tender & red
Management of a chalzion?
Hot compress & analgesia
- Consider topic antibiotics (chloramphenicol) if inflammed acutely
- Rarely if other management fails consider surgical drainage
What is an entopion?
Condition where the eyelid turns inwards with the lashes against the eyeball
Presentation of entropion?
Pain and can result in corneal damage & ulceration
Initial management of entropion?
Taping eyelid down to prevent it turning upwards
prevent the eye drying with lubricating drops
Definitive management for entropion?
Surgical intervention
What is ectropion?
Where the eyelid turns outwards with inner aspect of the eyelid exposed
This usually affects the bottom lid
What can ectropion result in?
Exposure keratopathy as the eyeball is exposed & inadequately lubricated/protected
Treatment of moderate ectropion?
Regular lubricating eye drops
Treatment of mild ectropion?
None required
Treatment of severe ectropion?
Significant cases require surgery to connect
What is trichiasis?
Inward growth of eyelashes
Presentation of trichiasis?
Pain and corneal damage/ulceration
Management of trichiasis?
Specialist removes eyelash (epilation) Recurrent cases get -Electrolysis -Cryotherapy -Laser treatment All to prevent eyelash regrowth
What is periorbital cellulitis?
Eyelid & skin infection infront of the orbital septum (the eye)
What is periorbital cellulitis AKA?
Preorbital
Presentation of preorbital cellulitis?
Swelling
Redness
Hot skin around eye
Which is sight threatening orbital cellulitis or preorbital cellulitis?
ORBITAL
Which investigation helps differentiate between preorbital and orbital cellulitis?
CT scan
Treatment of preorbital cellulitis?
Systemic antibiotics (oral or IV) Preorbital can develop into orbital in vulnerable patient such as children so may require admission to be observed
What is orbital cellulitis?
Infection around the eyeball involving tissues behind the orbital septum
Presentation of orbital cellulitis?
Pain on eye movement Changes in vision Reduced eye movements Abnormal pupil reaction Forward movement of eyeball (proptosis)
Management of orbital cellulitis?
MEDICAL EMERGENCY
Admit patient
IV antibiotics
May require surgical drainage if an abscess forms
