Lid lumps (eyelid disorders) and periocular tumours

Question 1

define blepharitis

Answer 1

inflammation of the eyelid margins

Question 2

presentation of blepharitis 3

Answer 2

gritty, itchy, dry sensation in the eyes

Question 3

what can blepharitis be caused by

Answer 3

dysfunction of the meibomian glands

Question 4

what is the function of the meibomian glands

Answer 4

secrete oil unto the surface of the eye

Question 5

what can blepharitis lead to 2

Answer 5

styes
and
chalazions

Question 6

management of blepharitis

Answer 6

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

Question 7

types of stye 2

Answer 7

hordeolum externum

hordeolum internum

Question 8

what is a hordeolum externum stye caused by 2

Answer 8

infection of either the glands of Zeis or glands of Moll

Question 9

what is a hordeolum internum stye caused by

Answer 9

infection of the meiobiam glands

Question 10

define the glands of moll

Answer 10

sweat glands at the base of the eyelashes

Question 11

define the glands of zeis

Answer 11

sebaceous glands at the base of the eyelashes

Question 12

presentation of styes 2

Answer 12

a tender red lump along the eyelid that may contain pus

Question 13

how does a horrdeolum internum stye present differently to a hordeolum externum stye 3

Answer 13

usually deeper
-tend to be more painful
-may point inwards towards the eyeball underneath the eyelid

Question 14

treatment for styes 2

Answer 14

hot compressess and analgesia

consider topical ABx (chloramphenicol) if assoc w conjunctivitis or persistent

Question 15

define a chalazion

Answer 15

when the meibomian gland becomes blocked and swells up
-often called a meibomian cyst

Question 16

how does a chalazion presnet 2

Answer 16

swelling in the eyelid that is typically not tender

it can be tender and red tho

Question 17

treatment of chalazion 3

Answer 17

hot compress and analgesia

consider topical ABx (chloramphenicol) if assoc w conjunctivitis or persistent

if conservative mangemtn fails (rarely)- consider surgical drainage

Question 18

type entropion

Answer 18

where the eyelid turns inwards with the lashes against the eye ball

Question 19

presentation of entropion 2

Answer 19

pain

can result in corneal damage
or
corneal ulceration

Question 20

management of entropion 2

Answer 20

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

Question 21

define ectropion

Answer 21

where eyelid turns outwards with inner aspect of eyelid exposed
-usually affects bottom lid

Question 22

what can ectropion cause

Answer 22

exposure keratopathy
-as eyeball is ecposed and not aequalty lubiracted and protected

Question 23

define exposure keratopathy

Answer 23

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.

Question 24

managemtn of ectropion 3

Answer 24

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

Question 25

define trichiasis

Answer 25

inward growth of eyelashes

Question 26

presentaion of trichiasis 3

Answer 26

pain -can result in corneal damage and ulceration

Question 27

managemtn of trichiasis 2

Answer 27

specalist remove eyelash- epilation recurrent cases may need electrolysis,cryoterpay or laser treatment to prevent lash regrowing risk to sight-same day referral

Question 28

define periorbital cellulits

Answer 28

also known as preorbital cellulits -eyelid and skin infection in front of orbital septum (in front of the eye)

Question 29

how does periorbital cellulits present 3

Answer 29

swelling redness hotskin (above found around the eyelids and eye)

Question 30

what is an improatnt differntial for periorbital cellulitis and how is this confirmed

Answer 30

important differnrtial is orbital cellulits -this is sight and life threatening emergency To distinguish -use CT scan

Question 31

management of periorbital cellulits 1

Answer 31

systemic ABx *-can develop into orbital cellulits so kids and vulnerable groups or severe cases may need admission to observe

Question 32

define orbital cellulits

Answer 32

infection around the eyeball that involves tissues BEHIND THE ORBITAL SEPTUM

Question 33

what key features differntiate orbital cellulitis from periorbital 5

Answer 33

pain on eye movement reduced eye movmemtns changes in vision abnormal pupil reactions proptosis (forward movement of eyeball)

Question 34

what key features differntiate orbital cellulitis from periorbital 5

Answer 34

pain on eye movement reduced eye movmemtns changes in vision abnormal pupil reactions proptosis (forward movement of eyeball)

Question 35

management of orbital cellulits 2

Answer 35

medical emergency required admission and IV ABx may need surgical drainage if abscess forms

Question 36

risk factors for orbital cellulits 5

Answer 36

childhood previous sinus infection no Haemophils influzae B vaccination recent eyelid infecton/ insect bite on eyelide ear or facial infection

Question 37

what usually causes orbital cellulits

Answer 37

spreading URTI from the sinuses

Question 38

IX for orbital cellullits

Answer 38

FBC full opthal exam *-CT WITH CONTRAST - inflammation of the orbital tissues deep to the septum, sinusitis

Question 39

define periocular skin caner

Answer 39

involes the skin of the eyelid or around the eye -usually occur on the lowereyelid

Question 40

most common types of periocular skin cancer

Answer 40

usually basal cell carincoma less common SCC, sebaceous gland carcinoma and malignant melanoma

Question 41

most common ocular tumour

Answer 41

choroidal melanoma

Question 42

treatment for periorcular skin tumours 2

Answer 42

prinicples -complete removal -reconstrution of eyelid