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The Eye > Lid Disorders > Flashcards

Lid Disorders Flashcards

1
Q

Blepharitis - Definition

A

Inflammation of the eyelid

Posterior - inflammation of the inner portion of the eyelid

Anterior - inflammation at the base of the eyelid

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2
Q

Blepharitis - Etiology

A
  • allergic conjunctivitis
  • cigarette smoking
  • contact lens
  • retinoid use
  • may be due to bacterial or fungal infection
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3
Q

Posterior Blepharitis - Epi and Pathophysiology

A
  • Roseacea
  • seborrheic dermititis

Chronic Infection

  • coagulase-negative staph
  • corynebacterium
  • cutibacterium acnes

Path: hyperkeritinization of the meibomian gland ductal epithelium which alters secretions and makes a bacteria-friendly environment

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4
Q

Anterior Blepharitis - Epi and Path

A
  • inflammation at the base of the eyelashes
  • Three types:
    • bacterial - scales and crusts (S. aureus and coag-negative staph)
    • parasitic - demodex mite
    • seborrheic - scales
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5
Q

Blepharitis - Symptoms

A
  • Red, swollen, itchy eyes
  • gritty burning sensation
  • excessive tearing
  • crusting of lashes
  • light sensitivity
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6
Q

Blepharitis - Signs

A
  • Anterior Bacterial - adherent material around lashes and colarettes
  • Anterior Mite - adherent material around lashes and sleeves
  • Anterior Seborrheic - greasy flakes
  • Posterior - enlargement of meibomian gland opening and plugging
  • All Forms - conjunctival injection and tear break-up time increased (which increases evaporative loss) - more likely in posterior
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7
Q

Blepharitis - Treatment

A

Mild to Moderate: Lid Hygiene Regimen

  1. warm compress
  2. lid massage
  3. lid washing
  4. artificial tears

Moderate to Severe:

  • topical abx, bacitracin ointment, erythromycin ointment
  • demodex - tea tree oil ophthalmic solution
  • ivermectin PO (anti-parasite)
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8
Q

Blepharitis - Patient Education

A
  • Lid hygiene routine
  • limit triggers (smoking)
  • dispose of old cosmetics and applicators
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9
Q

Chalazion - Definition

A

Inflammation and obstruction of the sebaceous glands of the eyelids

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10
Q

Chalazion - Signs and Symptoms

A
  • eyelid swelling and erythema followed by
  • a slow growing, rubbery, painless lesion
  • visible on inversion of lid
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11
Q

Chalazion - Treatment

A
  • time
  • lid hygiene routine may work
  • may need intralesional steriod injections to shrink lesion
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12
Q

Hordeolum - Definition

A
  • acute purulent inflammation of the eyelid
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13
Q

Hordoleum - Epi and Path

A

Epi - usually Staph bacteria

Internal - meibomian gland

External - “stye” - eyelash follicle or Zeis gland

May develop into chalazion

May become cellulitis

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14
Q

Hordoleum - Signs and Symptoms

A
  • painful (Hordoleum HURTS)
  • warm
  • swollen lump on eyelid (usually near margin)
  • red
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15
Q

Entropion - Epi

A
  • more common in elderly
  • can be caused by spasms of the orbicularis oculi muscle
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16
Q

Entropion - Definition

A
  • inward turning of the lower lidthat causes lashes to rub on the cornea causing irritation and scarring
17
Q

Entropion - Clinical Presentation

A
  • injection
  • corneal abrasion/ulceration
  • erythma of lower lid
  • tearing
  • Increased sensitivity
18
Q

Entropion - Rx

A
  • botox as a bridge to surgery
  • surgical repair
19
Q

Ectropion - Definition

A
  • outward turning of the lower lid that can lead to ocular dryness
20
Q

Ectropion - Epi

A
  • common in the elderly
  • due to weakness of canthal ligaments and orbicularis oculi muscle
21
Q

Ectropion - Signs and Symptoms

A
  • irritated red eye
  • tearing
  • constantly wiping eyes
22
Q

Xanthelasma - Definition

A
  • cholesterol-filled, soft, yellow plaques on the medial aspects of the eyelids
23
Q

Xanthelasma - Epi

A
  • 1/2 of patients have hypercholesterolemia
  • 3/4 older patients with familial hypercholesterolemia
  • middle-aged and older adults
24
Q

Xanthelasma - Treatment

A
  • cosmetic - they are harmless
  • check lipid panel in all patients with these lesions
25
Q

Basal Cell Carcinoma - Definition

A
  • malignant tumor of the eyelid
26
Q

Basal Cell Carcinoma - Epi

A
  • most common malignancy of the eyelid
  • fair skinned people
  • hx of sun exposure
27
Q

Basal Cell Carcinoma - Clinical Presentation

A
  • small
  • slow-growing
  • firm
  • painless
  • pearly color
  • indurated
  • telangiectasia (maybe)
28
Q

Basal Cell Carcinoma - Rx

A
  • surgical excision
  • Moh’s chemosurgery or excision with frozen section
29
Q

Squamous Cell Carcinoma - Definition

A
  • Less common malignancy of the lid, but faster growing than basal cell
30
Q

Squamous Cell Carcinoma - Path

A
  • Can be new lesion
  • can be transformation of actinic keratosis
31
Q

Squamous Cell Carcinoma - Presentation

A
  • lower lid margin nodule or plaque
  • everted edges
  • crusting
32
Q

Squamous Cell Carcinoma - Rx

A
  • confirm with biopsy
  • surgical excision is effective
  • radiation can be used as an alternative
    *
33
Q

Melanoma - Epi

A
  • 1% of all eyelid malignancies
  • 2/3 of tumor-related deaths
  • excessive sun exposure
  • genetic factors
  • caucasian race
  • changing skin nevi
34
Q

Melanoma - Clinical Presentation

A
  • irregular borders
  • discoloration (usually dark)
  • several varieties - nodular most common
35
Q

Melanoma - Rx

A
  • wide surgical excision
  • regional lymph node dissection if extension is suspected
36
Q

Hordoleum - RX

A

Lid Hygiene

37
Q

Ectropion - Rx

A

Artificial tears and surgical repair

The Eye (3 decks)

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