Eyelid/Eyelashes Flashcards
Hordeolum
Lid Cleaning
Warm compresses 15 mins BID-TID
Maxitorl ung TID x 7 days
If severe, consider Doxycycline 100mg qd or BID
OR Augmentin 500mg BID x 7 days
frequent follow ups are rarely necessary
Chalazion
Lid cleaning
Warm compresses
AB/Steroid combination drops or ointment
Doxycycline 100mg qd-bid
Incision and curettage
Intralesional steroid injection if needed
Photoiomodulation
Frequent follow ups are rarely necessary
Preseptal Cellulitis
Augmentin 875/125 mg bid
Bactrim 160/800 mg bid
Doxycycline 100mg bid
Every couple of days for reassessment
Blepharitis
Lid hygiene
Antibiotic/AB-Steroid combination drop/ointment
Oral Doxycycline 100mg bid
Azithromycin (Z-Pack)
Follow up: 2-4 weeks
Contact Dermatitis
Avoid irritating agents
artificial tears
Cool compresses
Steroid ointment/cream
Follow up: 1 week
Basal Cell Carcinoma
UV Protection
Biopsy
Surgical excision (Mohs Technique) is the gold standard
Follow up: 6-12 months
“Think BASAcally a rodent chewed ulcer”
Tumor usually in the lower lid or medial cants. Most common malignant eyelid tumor.
Sometimes referred to as “rodent ulcer”
Squamous Cell Carcinoma
UV protection
Biopsy
Surgical excision (Mohs Technique)
Chemotherapy
Radiation
Cryotherapy
Follow up: 6 months, sometimes sooner
“Think Squamous = Swollen nodule’
Much higher change of malignancy compared to BCC
Myokymia
“Eyelid Twitch”
Avoid precipitating factors such as fatigue, excess caffeine and stress or inadequate sleep.
Follow up is not necessary unless symptoms greatly worsen
Blepharospasm
Lid twitch/contractions
Observation
Botox injection into orbicularis muscle
In rare cases, myectomy may be considered.
Frequent follow up is not necessary unless symptoms greatly worsen.
Floppy Eyelid Syndrome
See Blepharospasm
Usually caused by sleep apnea machines.
Molluscum Contagiosum
Umbilicated, dome-shaped nodule on eyelid or in the periorbital region. Often multiple lesions *DNA virus spread by contact
Observation
Topical chemical removal
Cauterization
Surgical excision
Follow up: Every 2-4 weeks
**If severe, consider testing for HIV
Papilloma
Outward growth, usually pedunculate but sometimes sessile
Observation or surgical removal with biopsy
Frequent follow up is not necessary unless noticeable change in shape or size occurs
Ectropion
Outward lid turn/ conj injection and keratinization/corneal keratopathy
Topical lubrication
Topical AB or AB/steroid combo
Eyelid surgery
Follow up: Every 1-2 weeks during topical rx.
PRN based on symptoms.
Entropion
Inward lid turn; conj injection; corneal keratopathy; possible corneal scarring
Topical lubrication
Topical antibiotic
Botox injection
Eyelid surgery
Follow up: every 1-2 weeks during topical treatment
PRN based on symptoms
Ptosis
Upper eyelid droop
Observation
Spectacle eyelid crutch
Eyelid taping
**Upneeq Rx
Eyelid Surgery
Follow up: If benign, frequent follow up is not necessary
Trichiasis
Misdirected eyelashes/SPK
Observation
Topical lubrication
Epilation
Radiofrequency
Follow up: PRN based on symptoms
Madarosis
Eyelash and/or brow loss
Observation
Address underlying etiology
Hair transplant
Follow up according to underlying etiology and severity
Dermatochalasis
Redundant loos lid tissue causing vision reduction and possible irritation
Observation
Refer for blepharoplasty
Follow ups not required.
1-2 weeks following blepharoplasty
Ocular Rosacea
Eyelid and facial erythema/Telangiectasia causing dryness, irritation, burning sensation
Eyelid hygiene, intense pulsed light
Doxycycline 50mg qd
Omega-3 supplementation
Follow up: depends on severity
Significant symptoms follow up ever 4-6 months
Eyelid Coloboma
Missing eyelid tissue/Keratopathy
Often asymptomatic/Possible irritation
Observation
Topical lubrication
Eyelid reconstruction
Follow up: PRN based on symptoms
Poliosis
Whitening of hair (due to decrease in melanin)
Observation
Hair coloring for cosmesis
Follow up: frequent follow ups are not necessary
Seborrheic Keratosis
Waxy, scaly lesion. Usually dark with a “stuck on” appearance. Asymptomatic/possible irritation
Benign; looks like a multi-lobed mole
Observation
Biopsy
Excision
Follow up: frequent follow ups are rarely necessary
Xanthelasma
Yellowish lipid plaques usually near the upper, inner lid. Asymptomatic but possible irritation.
Evaluate patient for hypercholesterolemia.
Observation
Excision
Follow up: Not usually necessary unless significant increase.
Keratocanthoma
Dome shaped lesion, rolled edges, central plug
Asymptomatic but could cause irritation
Observation
Excision
Biopsy
Radiation therapy
Rule out squamous cell carcinoma
Follow Up: if definitive dx is made, follow ups not necessary
**Previously thought to be benign but considered by some to be a form of SCC
Demodex
Cylindrical sleeve/collarettes around lash follicle
Often asymptomatic, could cause irritation
Observation
Tea tree oil
Cliradex
Zocular
Follow up: Every 2-3 weeks during treatment
PRN if insignificant signs/symptoms
