Final: Eyelids 2

Question 1

Chalazion

Answer 1

-Inflammation of meibomian gland with accumulation of lipogranulomatous material.
(-) pain
(+) red, puffy, bump, may have discharge
-Most common in women 10-29 yrs, men >60

Management:
-Warm compress, massage (#1 treatment)
-Eyelid hygiene
-Oral doxycycline w rosacea/ MGD (100mg BIDx2 weeks) or 50 mg BID x 4 weeks
-Injection (Kenalog-40)

Question 2

Bleharochalasis

Answer 2

Recurrent inflammatory edema of the eyelids.
Associated with Ascher Syndrome
(+) repeated eyelid swelling, droopy eyelid w/ fine wrinkles
(-) pain, visual problems
Look at patient outside slit lamp

Manangement:
-self limiting within a few days
-if redundant skin, ptosis, or lacrimal gland prolapse, consider referral for blepharoplasty

Question 3

Ascher Syndrome

Answer 3

Eyelid swelling, narrow palpebral fissure, lip swelling(double lip sign), Euthyroid (non toxic goiter)

Question 4

Anterior Blepharitis

Answer 4

Chronic inflammation of eyelid margin anterior.
Staph: biofilm
Seborrheic: Excessive sebum released by sebaceous gland.
(+) crusty debris, red/pink eyelid, irritation, tearing
If seborrheic, greasy appearance.

Management:
-Lid hygiene (baby shampoo0
-topical lubricant
-BlephEx
-If severe, steroid or antibiotic ointment

Question 5

Demodex

Answer 5

(+) crusty, itching, redness, tearing
Crust is more cylindrical
Mites attach to base

Management:
-Tea tree oil

Question 6

Angular blepharitis

Answer 6

Infection of the epidermis in the temporal cants
(+) redness, discharge

Management:
-Eyelid cleanser
-Hypochlorous eyelid spray
-Antibiotic/ steroid ointment