Lid lumps (eyelid disorders) and periocular tumours Flashcards
define blepharitis
inflammation of the eyelid margins
presentation of blepharitis 3
gritty, itchy, dry sensation in the eyes
what can blepharitis be caused by
dysfunction of the meibomian glands
what is the function of the meibomian glands
secrete oil unto the surface of the eye
what can blepharitis lead to 2
styes
and
chalazions
management of blepharitis
hot compressess and gentle celeaning of the eyelid margins to remove debris using cotton wool dipped in sterilised water and baby shampoo
lubricating eye drops can be used to relive syx
-hypromellose
-polyvinyl alcohol
-carbomer
types of stye 2
hordeolum externum
hordeolum internum
what is a hordeolum externum stye caused by 2
infection of either the glands of Zeis or glands of Moll
what is a hordeolum internum stye caused by
infection of the meiobiam glands
define the glands of moll
sweat glands at the base of the eyelashes
define the glands of zeis
sebaceous glands at the base of the eyelashes
presentation of styes 2
a tender red lump along the eyelid that may contain pus
how does a horrdeolum internum stye present differently to a hordeolum externum stye 3
usually deeper
-tend to be more painful
-may point inwards towards the eyeball underneath the eyelid
treatment for styes 2
hot compressess and analgesia
consider topical ABx (chloramphenicol) if assoc w conjunctivitis or persistent
define a chalazion
when the meibomian gland becomes blocked and swells up
-often called a meibomian cyst
how does a chalazion presnet 2
swelling in the eyelid that is typically not tender
it can be tender and red tho
treatment of chalazion 3
hot compress and analgesia
consider topical ABx (chloramphenicol) if assoc w conjunctivitis or persistent
if conservative mangemtn fails (rarely)- consider surgical drainage
type entropion
where the eyelid turns inwards with the lashes against the eye ball
presentation of entropion 2
pain
can result in corneal damage
or
corneal ulceration
management of entropion 2
inital Mx- tape eyelid down to prevent it turning inwards
-whilst taped down use regular lubricating eye drops to prevent eye drying out
diffinitve mangemnt- surgical intervention
if risk to sight-same day referral to ophthal
define ectropion
where eyelid turns outwards with inner aspect of eyelid exposed
-usually affects bottom lid
what can ectropion cause
exposure keratopathy
-as eyeball is ecposed and not aequalty lubiracted and protected
define exposure keratopathy
damage to the cornea that occurs primarily from prolonged exposure of the ocular surface to the outside environment. EK can lead to ulceration, microbial keratitis, and permanent vision loss from scarring.
managemtn of ectropion 3
mild cases- no treatment
-regular lubricating eye drops are used to protect the surface of the eye
-more significant cases may require surgery to correct the defect
if risk to sight- same day referral
define trichiasis
inward growth of eyelashes
presentaion of trichiasis 3
pain
-can result in corneal damage and ulceration
managemtn of trichiasis 2
specalist remove eyelash- epilation
recurrent cases may need electrolysis,cryoterpay or laser treatment to prevent lash regrowing
risk to sight-same day referral
define periorbital cellulits
also known as preorbital cellulits
-eyelid and skin infection in front of orbital septum (in front of the eye)
how does periorbital cellulits present 3
swelling
redness
hotskin
(above found around the eyelids and eye)
what is an improatnt differntial for periorbital cellulitis and how is this confirmed
important differnrtial is orbital cellulits
-this is sight and life threatening emergency
To distinguish
-use CT scan
management of periorbital cellulits 1
systemic ABx
*-can develop into orbital cellulits so kids and vulnerable groups or severe cases may need admission to observe
define orbital cellulits
infection around the eyeball that involves tissues BEHIND THE ORBITAL SEPTUM
what key features differntiate orbital cellulitis from periorbital 5
pain on eye movement
reduced eye movmemtns
changes in vision
abnormal pupil reactions
proptosis (forward movement of eyeball)
what key features differntiate orbital cellulitis from periorbital 5
pain on eye movement
reduced eye movmemtns
changes in vision
abnormal pupil reactions
proptosis (forward movement of eyeball)
management of orbital cellulits 2
medical emergency
required admission and IV ABx
may need surgical drainage if abscess forms
risk factors for orbital cellulits 5
childhood
previous sinus infection
no Haemophils influzae B vaccination
recent eyelid infecton/ insect bite on eyelide
ear or facial infection
what usually causes orbital cellulits
spreading URTI from the sinuses
IX for orbital cellullits
FBC
full opthal exam
*-CT WITH CONTRAST - inflammation of the orbital tissues deep to the septum, sinusitis
define periocular skin caner
involes the skin of the eyelid or around the eye
-usually occur on the lowereyelid
most common types of periocular skin cancer
usually basal cell carincoma
less common SCC, sebaceous gland carcinoma and malignant melanoma
most common ocular tumour
choroidal melanoma
treatment for periorcular skin tumours 2
prinicples
-complete removal
-reconstrution of eyelid
