Eyelid Disorders Flashcards
What is blepharitis?
Inflammation of the eyelid margins.
What condition is this sensation describing: gritty, itchy, dry sensation?
Blepharitis
Dysfunction of which gland is associated with blepharitis?
Meibomian gland - responsible for secreting oil onto surface of the eye.
What what can gland dysfunction in blepharitis lead to?
Stye and chalazions
How is blepharitis treated?
Hot compress and gentle cleaning of eyelid margins to remove debris using cotton wool.
What are the three lubricating eyedrops that can be used in blepharitis?
- Hypromellose - least viscous, lasts 10 mins
- Polyvinyl alcohol - middle viscosity, start with these
- Carbomer - most viscous, lasts 30-60 mins
What are the two types of stye and which glands do they infect?
- Hordeolum externum - glands of Zeis/Moll
2. Hordeolum internum - Meibomian glands
What is this a typical presentation of: tender red lump along the eyelid which may contain pus?
Stye
What is the treatment for stye?
Hot compress and analgesia, consider topical antibiotics (chloramphenicol) if associated with conjunctivits/persistent.
How does a chalazion cyst occur?
When the Meibomian gland becomes blocked and swells up.
What is this a typical presentation of: swelling in the eyelid, typically non-tender?
Chalazion
What is the treatment for chalazion?
Hot compress and analgesia, topical antibiotics (chloramphenicol) if acutely inflamed. May need surgical drainage (rare).
What is entropion?
Eyelid turns inwards with lashes against the eyeball.
What is this a typical presentation of: eyelid turned in with pain, corneal damage and ulceration.
Entropion
What is the treatment for entropion?
Tape eyelid down to prevent it turning inwards, use regular lubricating eyedrops.
Definitive management is surgical intervention.
Same day referral to ophthalmology if there is a risk to sight.
What is ectropion?
Eyelid turns outwards with inner aspect of eyelid exposed, usually bottom lid.
What is the main complication of ectropion?
Exposure keratopathy (eyeball not adequately protected)
What is the treatment for ectropion?
Mild cases do not need treatment except lubricating eye drops. More significant cases need surgery.
Same day referral to ophthalmology is there is a risk to sight.
What is this a presentation of: inward growing of the eyelashes, pain, corneal damage and ulceration?
Trichiasis
What is the treatment for trichiasis?
Removal of eyelash, if recurrent then may require electrolysis/cryotherapy/laser treatment.
Same day referral to ophthalmology if there is a risk to sight.
What is this a presentation of: swelling, redness, and hot skin around eyelids and eye (in front of eye)?
Periorbital cellulitis
What is an important differential diagnosis for periorbital cellulitis and how is it distinguished?
Orbital cellulitis, CT scan.
What is the treatment for periorbital cellulitis?
Systemic antibiotics, severe cases may require admission which treat in case of development into orbital cellulitis.
What is this a presentation of: swelling, redness, and hot skin around eyelids and eye, pain on eye movement, vision changes, abnormal pupil reactions, proptosis?
Orbital cellulitis (emergency)
What are the risk factors for orbital cellulitis?
Childhood, previous sinus infection, lack of Hib vaccination, periorbital cellulitis, ear/facial infection.
What is the treatment for orbital cellulitis?
Medical emergency - admission and IV antibiotics, may require surgical drainage if an abscess develops.
