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Ophthalmology > Lid and Lacrimal Disorders > Flashcards

Lid and Lacrimal Disorders Flashcards

1
Q

Karatoconjunctivitis Sicca (KS)

A
  1. Lacrimal gland dysfunction or destruction
  2. Increased evaporation loss
    - commonly caused by meibomian gland dysfxn
    - structural abnormalities
    - decreased blink fxn
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2
Q

KS Findings

A

Conjunctival injection
Excessive tearing
Blepharitis
Often need optho referral

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3
Q

KS Tx

A 
Blepharitis:  Eye hygiene
Avoidance if allergies
True KS:
 1. Fake tears
 2. Environmental strategies?
 3. Topical cyclosporine (Restasis)
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4
Q

Dacrocystitis

A

An infection of the lacrimal sac and is often associated with a blocked duct.

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5
Q

Dacrocystitis Causes

A 
Nose injury
Eye infxn/tumor
Nasal inflammation
Old Age
Blocked tear duct
Obstruction of nasolacrimal duct
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6
Q

Dacrocystitis Tx

A

Warm compress
Oral antibiotics (bactrim, clindamycin)
Careful follow up
If persistent, refer to optho

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7
Q

Dacrostenosis

A

Nasolacrimal duct obstruction

  • Can occur anywhere in lacrimal drainage system
  • Most common at membrane of Hanser
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8
Q

Dacrostenosis is seen primarily in which population?

A

Newborns and infants

  • Persistent tearing
  • Acular discharge
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9
Q

Dacrostenosis Tx

A

Massage 2-3 times/day
Probing(?) by an optho
Don’t get weird

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10
Q

Hordeolum (Stye)

A

A localized infection OR inflammation of the eyelid margin involving either:

  • Hair follicles of eye lashes (external)
  • Meibomian Glands (internal)
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11
Q

Which bacteria is most often associated with a stye?

A

Staph Aureus in 90-95% of cases

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12
Q

Both internal and external styes can srise as a secondary complication to which other disease?

A

Blepharitis

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13
Q

Chalazion

A

AKA meibomian gland lipogranuloma
A PAINLESS mass arising from chronic granulation of a stye.
- If large enough can cause visual disturbance.
- generally disappear w/o tx in a few months, and certainly within 2 years

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14
Q

Pertinent negatives for styes

A

Absence of constitutional symptoms
Absence of periborbital involvement
Preauricular lymph nosed are NOT enlarged

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15
Q

Stye Tx

A

Generally self-limiting
Warm compresses
Abx if infection spreads beyond initial area
Consider eyelash removal to help with draining

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16
Q

Should the patient squeeze the stye?

A

Really? No.

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17
Q

Blepharitis

A

Inflammation involving structures of the lid margin and involves:
- erythema
- scaling
- crusting
Often associated with systemic conditions

18
Q

Blepharitis Patho

A

Bacterial colonization of the eyelids
Direct invasion of tissues
Generally seen in ages 50 and older

19
Q

Blepharitis presentation

A
  • Burning, watering, crusting of lashes and medial canthus, scaling, erythematous eyelids.
  • chronic course with intermittent exacerbations
  • May be some conjunctival injection
20
Q

Blepharitis Tx

A

Eyelid margin hygiene!
Application of heat
Antibiotic ointment (erythro)

21
Q

Blepharitis can be easily cured: T or F

A

False, it is a chronic condition. educate the patients about this.

22
Q

Ectropion

A

Eversion of the eyelid margin away from the globe.
Generally requires surgical repair
Eyedrops and ointments can be used to treat symptoms and protect eye.

23
Q

Causes of ectropion

A

Aging, scarring, loss of tone, infxn, palsy of facial nerves

24
Q

Entropion

A

Inversion of the eyelid toward the globe.

- muscle weakness, scarring, infections

25
Q

Entropion tx

A

Surgery, lubricants

26
Q

Pterygium

A

A corneal proliferative disease associated with UV exposure that arises form limbus and proliferates

  • Can move to cornea
  • Generally asymptomatic and zero consequence
27
Q

Pinguecula

A
  • Often associated with pterigium
  • Appears as yellowish growth of scleral conjunctiva adjacent to limbus.
  • Will not encroach onto cornea
  • Generally asymptomatic
28
Q

Capillary Hemangomia

A

Superficial tumor that develops strawberry appearance
1/3 diagnosed at birth
90% visible by 6 months

29
Q

Capillary Hemangomia Complications

A
  • Amblyopia, astigmatism

- Superinfection, ulceration

30
Q

Capillary Hemangomia Tx

A
  • Steroids, interferon
  • Radiation therapy
  • Surgical rescection
31
Q

Conjunctival Hemangomia

A

Red blood-filled growth on conjunctiva

32
Q

Conjunctival Hemangomia Tx

A

May not need tx
May cause amblyopia, strabismus
Almost all disappear by age 9
Laser can remove in some cases

33
Q

Lacrimal Gland Tumors

A
  • Enlargement of lacrimal fossa, no inflammatory signs
34
Q

Pleomorphic Adenoma

A

Benign mixed Lacrimal tumor
20-50 years of age
Excision Tx
Painless globe displacement

35
Q

Adenoid Cystic Carcinoma

A

Most common malignant lacrimal tumor.
Pain and numbness
50% mortality, requires agressive surgery

36
Q

Basal Cell carcinoma (BCC)

A 
Most common human malignancy
Usually effects elderly
Does not metastasize
90% of head or neck
90% of eyelid malignancies
Tx is excision
37
Q

Squamous Cell carcinoma

A

Less common but more aggressive than BCC
Arise from solar damage
Most common of bottom eyelid
Tx: Excision, radiation

38
Q

Meibomian Gland Carcinoma

A 
AKA sebaceous cell carcinoma
Lethal eyelid malignancy
Error and delay in dx is common
Commonly occur in upper eyelid
50% mortality
Tx:  Excision and radiation
39
Q

Melanoma

A

Very aggressive, rapid spread.
Affects choroid, conjunctiva, ciliary body, eyelid.
Tx: excision and possibly radiation

40
Q

Karposi Sarcoma

A
  • Malignant, vascular tumor that occurs mainly is AIDS patients.
  • Usually associated with advanced disease
    Tx: chemo, radiation
41
Q

Merkel Cell Carcinoma

A 
Rare, agressive malignancy
Metastasizes early to lymph nodes
Intact overlying skin
Most common on upper eyelid
treatable if caught early
Tx:  excision, radiation, chemo

Ophthalmology (12 decks)

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