Lacrimal Disorders And Thyroid Eye Disease Flashcards
1
Q
Dacrocystitis-
Etiology
A
Etiology
-lacrimal obstruction
S aureus
B-hemolytic strep
Staph epidermis
Candida
2
Q
Graves Ophthamopathy (Thyroid Eye Disease)- Etiology
A
Etiology
-autoimmune disorder
-may occur in patients without hyperthyroidism
-Hasimoto's thyroiditis
-Risk factors
Women more common than men
Men more likely severe cases
Smoking
3
Q
Dacryoadenitis-
Etiology
A
Etiology
Acute
- mumps
- EBV
- staph
- gonococcus
Chronic
- sarcoidosis
- thyroid eye disease
- orbital psuedotumor
4
Q
Dacryoadenitis-
Clinical Presentation
A
Clin Presentation
- usually sterile inflammation of lacrimal gland (lateral exocrine gland)
- G+ bacteria infection (RARE)
- Histology: Plasma cells, lymphocytes, eosinophils
5
Q
Dacryoadenitis-
Management
A
Tx
- Steroids
- Chronic dacryoadenitis less responsive to steroids
6
Q
Dacryocystitis-
Clinical Presentation
A
Clin Presentation
- lacrimal sac distended and erythematous
- discharge and tenderness (I&D)
- BELOW medial canthus
- Pain
7
Q
Dacryocystitis-
Differential Diagnosis
A
Differential diagnosis
-Neoplasm
Mass ABOVE medial canthus
Blood discharge or irrigation
Papilloma and squamous cell carcinoma
MRI/CT to rule out
8
Q
Dacryocystitis-
Management
A
Tx
-mildly tender: warm compress/antibiotics
-non-tender without discharge
Infants: massage
Adults: irrigate
9
Q
Grave’s Ophthalmopathy (Thyroid Eye Disease)-
Clinical Presentation
A
Clin Presentation
- Upper eyelid retraction
- sympathetic overstimulation of Muller muscle
- later enlargement of superior lavator complex
- restrictive EOMs
- Proptosis
- Compressive optic neuropathy (CON)
10
Q
Grave’s Ophthalmopathy (Thyroid Eye Disease)-
Management
A
Tx
- Usually mild and non progressive, most improve spontaneously
- corneal lubrication
- monitor/treat thyroid status
- IV methylprednisolone
- orbital radiation
- antioxidants (selenium)
- surgery
